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Is product has been c eveloped solely for mental use only by Weld County.The GIS atabase
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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 it: Date: S7Z¢ er
RE # : pz 6C-44r pz 6,4 Other Case#:
1. Applicant Name Michael Chalona Phone 970.472.8954 #1
Address 1136 E. Stuart St. Suite 2040 City Fort Collins State CO Zip 80525
2. Address or Location of Access
Section 29 Township 9 N. Range 67 W. Subdivision Block Lot C
Weld County Road #:17 Side of Road West Distance from nearest intersection
3. Is there an existing access(es) to the property? Yes No ✓ # of Accesses 1
4. Proposed Use:
❑ Permanent J4Residential/Agricultural ❑ Industrial
❑ Temporary ❑ Subdivision ❑ Commercial ❑ Other
5. Site Sketch
Legend for Access Description: ___Jd/
AG = Agricultural <r(a6 H
RES = Residential
O&G = Oil&Gas S,07.-
..---- D.R. = Ditch Road
t7 = House N
O = Shed A
46
A = Proposed Access J
• = Existing Access
NT 46 Fs5
A-6 "`-
7 /46 61 _,
OFFICE USE ONLY:
Road ADT Date Accidents Date
Road ADT Date Accidents Date
Drainage Requirement Culvert Size Length
Special Conditions
❑ Installation Authorized ❑ Information Insufficient
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Reviewed By: Title:
-17-
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