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05/07/02 09:33 FAX 970 304 i8 WELD PLANNING ,. a015
APPENDIX B
WELD COUNTY ROAD ACCESS INFORMATION SHEET
Weld County Public Works Department Date: 5 /1/ZOO
1111 U Street,P.O.Box 758, Greeley,CO 80632
Phone: (970)356-4000,Ext. 3750 Fax: (9770)p304-6497
1. Applicant Name .L A j N�F - / Ii-? Phone
Address %5 t (•l 5 \Y ;L7 4City PD tT LDL(dNSState_a)Zip
2. Address or location of access G P A 8 `6
Section 1 Township Iv' Range 6 6\\/
Subdivision Block Lot
Weld County Road # 84 Side of Road
NO T/{ Distance from nearest intersection Z£100
`3. Is there an existing access to the property? Yes 7. No #of accesses
4. Proposed Use:
O Permanent ❑ Residential/Agricultural
❑ Industrial O Temporary
Subdivision O Commercial ❑ Other
*******************************************************************************.*************
5. Site Sketch
Legend for Access ,��{{�
Hti
Description: ,4U
ca.\ AG = Agricultural
( RES = Residential
O&G= Oil&Gas
D.R. = Ditch Road
AGE
ws�
*********************
*******************
OFFICE USE ONLY:
Road ADT Date Accidents Date
Road ADT Date Accidents Date
Drainage Requirement Culvert Size Length
Special Conditions
❑ Installation authorized O Information Insufficient
Reviewed By: Title:
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