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It : f 8 [j .I a1 'E r !.11011 '1;12 'ag6`£ 1 C ; st sl •dS CPI .!F , d ,t g.s1:o.o ° 1 .'a s%1 s s £1 W 442 o i Y= L ' rs 10 r ; J I 7,fsati;g v 7yt li€ gEa}1•2ggi: ,6£3a g yr_E a Fti tf ill , �: Ili 2.: ;fit J! g S4 e.. at a€ g yt F1`stt5• £y 1: ai.₹ ` ie.E s t '� egg ! 4 e a 4SEa 1014 E it- i11F i-11'; h. e5Y °] t Ili —II NI .1 } 2i 5 :Egs.so3 s%e a_ jo° ggxfrtiaE£ESb ma' z N , e `�) B 1-i di`sd jai W V ' f- r, 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: J11'or RE # : Other Case #: 1. Applicant Name i,Vll/ja" li, Cessna any 64101 I. Cecfgp Phone (97a) M- 3757 Address /9533 S;furr Oat ta'e Fatt Maven- City fed 7yeye[5 State / Zip 337/2 2. Address or Location of Access P/arooel fta cs ZVI/ fast o)[ lea 19 a4 S Self! 0f 4,'(R Ty Section /0 Township 7* Range 67u/ Subdivision _ Block - Lot Weld County Road #: g7 Side of Road SOUP/ vv Distance from nearest intersection Z IMO Fuji of !VI77 3. Is there an existing access(es)to tie property? Yes X No #of Accesses I ill- 4. Proposed Use: Permanent ❑ Residential/Agricultural ❑ Industrial ❑ Temporary ,}S Subdivision U Commercial ❑ Other 5. Site Sketch Legend for Access Description: t! LI 3 AG = Agricultural `� G/�Q I'y RES = Residential 1 O&G = Oil&Gas 1 D.R. = Ditch Road tJ = House t O = Shed \ o- t \ A = Proposed Access x;,.4\ 't • = Existing Access9 �"-/ N ft NithC 3 I / fa i I Fxis1):,11 4 4((ess to h ahaedood a h Prot 1J keg/ Stlh9/t1;3(af 1ae55 Se Hwy Pi n 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: -17- Hello