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Road File#
RE:
Other Case No.
APPENDIX B
WELD COUNTY ROAD ACCESS INFORMATION SHEET
Weld County Public Works Department Date:\V�\G--1 )\-
1111 H Street,P.O. Box 758, Greeley, CO 80632
Phone: (970)356-4000, Ext. 3750 Fax: (970)304-6497 �\ `\
1. Applicant ame �C�11.�'�\�C -�� 1C \ s.- -.) tone S\�7�S2`-1�>\Q
Address\�` _ L City State Zip
2. Address or location of access " \ ks4 '-- �c hp C-.
Section Township Range
Subdivision Block Lot
Weld County Road # Side of Road S-s, � Distance from nearest intersection
3. Is there an existing access to the property? Yes No #of accesses tD"
4. Proposed Use:
❑ Permanent 161. Residential/Agricultural ❑ Industrial
❑ Temporary Subdivision ❑ Commercial ❑ Other
*********************************************************************** ********************************
5. Site Sketch O/ 9 1s
Legend for Access Description: A
AG= Agricultural
RES = Residential ����_� '
O&G= Oil &Gas
D.R. = Ditch Road I0°. •
0 = House
O = Shed 70 Pco,7fI5
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************************************
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:
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