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Address or Location of Access Section 29 Township 1N Range 66W Subdivision Block Lot Weld_ County Road#: 6 Side of Road South Distance from nearest intersection 1/2 mile East of CR 27 3. Is there an existing access to the property? Yes X No #of Accesses 1 4. Proposed Use: ❑ Permanent ❑Residential/Agricultural ® Industrial ❑ Temporary ['Subdivision ❑Commercial ❑Other _ J 5. Site Sketch ` a 0. Legend for Access Description: o_ AG = Agricultural RES = Residential O&G = Oil&Gas _ G P.6 D.R. = Ditch Road N AQop = House 0 = Shed oc • = Proposed Access v �, = Existing Access i -1-----1 A L> GF. Lt r"...... *************************************** 41/ OFFICE USE ONLY: Road ADT Date Accidents Date Road ADT Date Accidents Date Drainage Requirement Culvert Size Length Special Conditions El Installation Authorized ❑ Information Insufficient Reviewed By: Title: • APPLICATION ASSISTANCE AND OFFICE LOCATIONS -6- T. 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