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I I RECORDED EXEMPTION NO. 1473-20-4-RE 1747
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44. 4nd1fF /\®^' WELD COUNTY NOD 0
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 #: Date:
RE# : Other Case #:
1. Applicant Name Sohn € G le Phone 31)3* ]o551 Ilan
Address I• 11 City /7,, State
n L Rfl,Zip A,
2. Address or Location of Access t f,1Q3 FILM/ r- 11, W, Hudson / ovt04z
Section 20 Township . Range /ISM.) Subdivision u/A- Block I�/A LotK/A
Weld County Road #: 11W Side of Road Distance from nearest intersection .1 Mi..
3. Is there an existing access(es)to the property? Yes X No #of Accesses
4. Proposed Use:
❑ Permanent ❑ Residential/Agricultural ❑ Industrial
❑ Temporary ❑ Subdivision ❑ Commercial ' Other I-10me Bu5irKx
5. Site Sketch
Legend for Access Description:
AG = Agricultural
RES = Residential
O&G = Oil 8 Gas
D.R. = Ditch Road ti
= House
= Shed RL
A = Proposed Access ` V
• = Existing Access ry`
/k ti
N r AG,
g-D �
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:
-8-
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