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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: Great Western Oil and Gas Company, LLC Phone: 970-351-0733
Address: P.O. Box 336337, Greeley, CO 80633
2. Address or Location of Access: Just west of North Quarter Corner
Section: 26 Township: 6N Range: 67W Subdivision Block Lot
Weld County Road#: 66 Side of Road: South Distance from nearest intersection: 2,660±
3. Is there an existing access(es) to the property? Yes X No #of Accesses 1
4. Proposed Use:
X Permanent ❑ Residential/Agricultural ❑ Industrial
❑ Temporary ❑ Subdivision ❑ Commercial X Other: Oil &Gas Production
5. Site Sketch
Legend for Access Description:
AG = Agricultural
RES = Residential I , WCR 66 L_
.-- O&G = Oil&Gas
D.R. = Ditch Road O&G
0 = House
O = Shed n
26
O = Proposed Access
A = Existing Access c'
N (WCR 64) 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:
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