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W M.c1?/�oaN an', _ _� I\.a000i q " �� 8 do/L/O . no1SMOJ 7g_ p ty e , c., s®n I I aDL SOX, . cnzr ..cos, aiov o, j I D $ : ^8 N m N �Ib 0 �a V �o N®I V ,g N .a N ei $ 8 k-_ae-m- .-sue- <_„ - _.zovz-s` c�`_ _7-_ a-'.aoaa- ___ 1 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 Charles F. Phyllis Nelson & Gary Wi edeman Phone 971-n44n Address 1454 Red Fox Circle,/5880 W. 49th Citywindcnr/r,reeley State_co_Zip g063t 2. Address or Location of Access Section 26 Township 5N Range F,6w Subdivision Block 1 Lot9. 10, 11 Weld County Road #: Side of Road YellowstonDistance from nearest intersection 350 ft 3. Is there an existing access(es)to the property? Yes x No #of Accesses 1 each 4. Proposed Use: ❑ Permanent U Residential/Agricultural O Industrial ❑ Temporary O Subdivision O Commercial ❑ Other • 5. Site Sketch Legend for Access Description: -I L----------,\ AG = Agricultural D c fl t` 7 i in ' RES = Residential \ O&G = Oil&Gas j D.R. = Ditch Road 2 O = House C - r, O = Shed `� A = Proposed Access s y A = Existing Access .4 3 / c. Si NT f � �� 7,.../ , 7 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: -8- Hello