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Todd Hodges Design, LLC
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FEMA FIRM Community Panel # 080266 0475 D
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1269 North Cleveland Avenue • Loveland, Colorado 80537 • (970) 613-8556 • fax: (970) 613-8775
email: toddhodgesdesign@earthlink.net
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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 80832
• Phone: (970)356-4000,Ext.3750 Fax: (970)3046497
Road File e: Date:
RE*:_ _ Other Case 0: _
1. Applicant Name Christine Frederick Phone 56151 219-4022
Address 2090 Hollis Crossing Road cityCtinbellODGfumace Slate la_ 37051
2. Address or Location of Access
Section 15 Township 7N Range 67W Subdivision__Block Lot
Weld County Road a: BO Side of Road N Distance from nearest intersection approx. 1/2 mile
3. Is there an existing accesses)to the property? Yes X No_^ 4 of Accesses 1
4. Proposed Use:
® Permanent 0l Residential/Agricultural U Industrial
❑ Temporary a Subdivision U Commercial Cl Other
5. Site Sketch
Legend for Access Desedptlon:
A AO a Agricultural
RES = Residential
O8G a ON 8 Gas ---
D.R. = Ditch Road
O = House
7 = Shed
A =Proposed Access �...,
• =Existing Access
NOTE: See attached plat for greater detail. WCR :0 ^ ^ ^
Usting RES Access
Proposed RES Access
OFFICE USE ONLY: Proposed AG Access
Road ADT Date Accidents - Date
Road ADT Date Accidents Date
Drainage Requirement Culvert Size Length
Special Conditions
a Installation Authorized O Information insufficient
Reviewed By: _ Title:
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