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E S I SUBDIVISION EXEMPTION NO 0803-16-4 SE-1025
Situate in the Southeast Quarter of Section 16, �
Township 6 North, Range 65 West of the 6th p.m„ I.
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WELD COUNTY ROAD ACCESS INFORMATION SHEE
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 He#: Date:
I1,�/�,, 651402_Other Case#:1. Applicante_ �C - ii--�,`''`t Phone v --SciO
Address � � City(,-;licetipc.d. State OD Zip
2. Address o Location of Access
Section [Q -_ Township (I'LL__ Range r.a Subdivision /41/0I- Block /y/4 Lot
Weld County Road #: 3L Side of Road 1`10P#- Distance from nearest intersection 43 IM4- E. of weicq(
3 Is there an existing access(es) to the property? Yes X No #of Accesses
4. Proposed Use:
❑ Permanent Residential/Agricultural O Industrial
O Temporary Subdivision U Commercial Cl Other
5. Site Sketch
Legend for Access Description:
AG = Agricultural
RES = Residential
O&G - = Oil&Gas
• = Ditch Road
• = House
O = Shed
A = Proposed Access 1
¢r
• = Existing Access i
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OFFICE USE ONLY:
Road ADT Date _ Accidents Date
Road ADT Date Accidents Date
Drainage Requirement Culvert Size Length
Special Conditions
U installation Authorized U Information Insufficient
Reviewed By _ Title:
-7-
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