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WELD COUNTY ROAD ACCESS INFORMATION SHEET
Road File#: Date:
RE# :
Other Case#: 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
1. Applicant Name FlalalC44O ate-C-111 Phone 916-WNe/- 0247 -
Address (4 SQ Sz..4 ! Cr, City lacrni4f-dvset State co Zip 8as.t 8-
2. Address or Location of Access rf-1Pileu,kel tee ec* 4a 3 4- c,7r-
Section C Township IFN Range Le 5-6-4.) Subdivision Block Lot
Weld County Road#: Side of Road Distance from nearest intersection
3. Is there an existing access(es)to the property? . Yes ✓ No #of Accesses
4. Proposed Use:
❑ Permanent ‘Residential/Agricultural ❑ Industrial
❑ Temporary ❑ Subdivision ❑ Commercial ❑ Other
******************************************************************************************************'H***********************
5. Site Sketch
Legend for Access Description: • _____I I
AG = Agricultural L_
RES = Residential
O&G = Oil &Gas N� 40
D.R. = Ditch Road )
O = House �y W.
O = Shed
NI
4e
V
II I f
***************************************
OFFICE USE ONLY:
Road ADT Date Accidents Date
Road ADT Date Accidents Date
Drainage Requirement Culvert Size Length
Special Conditions g
❑ Installation Authorized ❑ Information Insufficient
Reviewed By:
Title:
-19-
File contains oversized
Magpie Operation - Oil and
Gas Well Exhibit Map
Please see original in File
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