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WELD COUNTY ROAD ACCESS INFORMATION SHEET
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
Road File #: Date: _
RE # : Other Case #:
1. Applicant Name Alaf-han G-e recur cc Phone 970— 669 -)463
Address / 739 S cot,.ih, Rc! 136 City LoveiCcir State CO Zip 80537
2. Address or Location of Access
Section IR Township `5 Range A 7 Subdivision Block Lot
Weld County Road #: 13 Side of Road East Distance from nearest intersection Atfmr( t 2r"t'ri he
3. Is there an existing access(es)to the property? Yes ✓L No # of Accesses
4 Di r+ Dr vei•Lia� fa acre -Silo-1 , 5
4. Proposed Use:
❑ Permanent ❑ Residential/Agricultural ❑ Industrial /�
U Temporary ❑ Subdivision Commercial )1 Other A3 recu t-1-0rc./
5. Site Sketch
Legend for Access Description:
AG = Agricultural
RES = Residential C R 58O&G = Oil&Gas
-'-- D.R. = Ditch Road ( Hull 34)
n = House
O = Shed
MA-0,1O-5-4 raocr
A = Proposed Access
Su re
, aas
A = Existing Access o'se
NT
cR56
7IF**********.***** ***********•{****•_
OFFICE USE ONLY: In to
cC CC
Road ADT U U
Date Accidents Date
Road ADT Date Accidents Date
Drainage Requirement Culvert Size Length
Special Conditions
❑ Installation Authorized U Information Insufficient
Reviewed By: Title:
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