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WELD COUNTY ROAD ACCESS INFORMATION SHEET
• Road File#: Date: 9-20-O-1
RE#:
Other Case#: Weld County Department of Public Works
111 H Street, P.O. Box 758, Greeley, Colorado 80632
Phone: (970)356-4000, Ext. 3750 Fax: (970) 304-6497
i�1. Applicant Name Spfcer anckes1 Li-t( Phone `f5H-4145
Address 37 '!'i O LJ C iC it 3 City Ga-fon State Co Zip 40(o IS'
2. Address or Location of Access 37'14'o A G R 4 3
Section 2-1 Township 7 Range GS Subdivision Block Lot
Weld County Road#: 4 3 Side of Road Cas-f- Distance from nearest intersection .Z'175'
3. Is there an existing access(es)to the property? Yes X No #of Accesses
4. Proposed Use:
❑ Permanent * Residential/Agricultural ❑ Industrial
❑ Temporary ❑ Subdivision ❑ Commercial ❑ Other
............................................„..*•*******,,,,,,,,,,,,,..........***,,,,,,,,,..,......_,___.,.,_,.........*****`
5. Site Sketch
Legend for Access Description:
AG = Agricultural
L_
RES = Residential
O&G = Oil&Gas
D.R. = Ditch Road
0 = House
= Shed
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OFFICE USE ONLY:
Road ADT Date Accidents Date
Road ADT Date Accidents Date
Drainage Requirement Culvert Size Length
Special Conditions
❑ Installation Authorized ❑ Information Insufficient
Reviewed By: Title:
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