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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#: Date:
RE# : Other Case#:
1. Applicant Name ALtole— Ttu-( c/C- Phone 970 - )35 - `13x0
Address rn i cwt r'. AL City kari9vv," - State Cu Ziplcsvy
2. Address or Location of Access Z a. cv<5 co-t5•4 a+ 4.-6:4-Q--
Section C? Township 2 Range L,1 Subdivision Block Lot
Weld County Road#: 73 L. Side of Road Distance •from nearest intersection'/`i' i
3. Is there an existing access(es)to the property? Yes S' No #of Accesses 2.--
4. Proposed Use:
Ire Permanent Residential/Agricultural ❑ Industrial
❑ Temporary ❑ Subdivision ❑ Commercial 0 Other
*******************************************************************************************************************************
5. Site Sketch
Legend for Access Description: •
AG
= Agricultural
RES = Residential
O&G = Oil&Gas
D.R. = Ditch Road
= House
O = Shed
= Proposed Access
• = Existing Access
NT
4CrILC-5i/a
5-
32- 7
***************************************
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-
2005-0216
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