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APPENDIX B
WELD COUNTY ROAD ACCESS INFORMATION SHEET
Weld County Public Works Depatlatent Date: p p - Ce
1111 H Street, P.O. Box 758, Greeley, CO 80632
Phone: (970)356-4000, Ext. 3750 Fax:( (970) 304-6497
1. Applicant Name Steven All t Cori Cullen stem Phone tin)`/q-eti/8
Address �?I� ,'honnn NV Cent?
r,, City LCoh$14Hd State CO Zip Pin
2. Address or location of access of W CR ?t W7 CR Z9.5
Section 14 Ye Z T9wnsh}'p 2 Al Range E/ W
Subdivision ftq eie4 ` fleaIlooTh'Hintitr Block Lot
Weld County Road # 21. 5- Side of Road West
West Distance from nearest intersection 670
3. Is there an existing access to the property? Yes X No #of accesses
4. Proposed Use:
❑ Permanent ❑ Residential/Agricultural
❑ Industrial O Temporary
Subdivision (6 kb)j) O Commercial ❑ Other
5. Site Sketch
Legend for Access T
Description:
AG = Agricultural Em°
RES = Residential
O&G= Oil&Gas D.R. = Ditch Road Moorcv In
Honor
Rte'+ 3
REs o wrR zits •
RES 0)
*********************
& AG
*******************
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:
15
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