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Road File#
RE. �_
APPENDIX B Other Case No.
____________
WELD COUNTY ROAD ACCESS INFORMATION SHEET
Weld County Public Works Department
1111 H Street,P.O.Box 758, Greeley, CO 80632 Date:
Phone: (970)356-4000,Ext.3750 Fax: (970) 304-6497
1. Applicant Name S I1 NW NI + SrA CEy (,\Z Ea biau S
E.Address `IVY / ACo•)1-14- L1J Phone State Co Zip
CityJ4��5iawy\ State c� Zip$oCaw/
2. Address or location of access
Section c32- Township .1 /f Range 6'7 wits s-
Subdivision
Weld County Road # 50 Block Lot
Side of Road hug-A-4‘ Distance from nearest intersectiona ftti
on
-
3. Is there an existing access to the property? Yes Z
X No #of accesses
��
4. Proposed Use: V S A C.0 5 S yO �11e 1\ Intl dig A-5
O Permanent re,P
ILS
Residential/Agricultural 0 Industrial
❑ Temporary ❑ Subdivision
** omm********************************************************* ***C ****l Other
*** * *****************************
5. Site Sketch
Legend for Access Description: I IAG= Agricultural RES = ResidentialL_ ....__ . h�i„
{
COLORADO
,^,O&G= Oil&Gasp�
).R. = Ditch Road •
O = House Jt`\
O = Shed u
T
1, R
_ '7************************************
****************************************#******************************
OFFICE USE ONLY:
Road ADT
Road ADT Date Accidents Date
ADT Date ' Accidents Date
Drainage Requirement Culvert
Size Length
Special Conditions
'a'
0 Installation authorized
0 Information Insufficient
Reviewed By:
Title:
m:wpfiles\engineer\access
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