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WELD COUNTY ROAD ACCESS INFORMATION SHEET
Feld County Public Works Department Date:
11 I I H Street, P.O. Box 758, Greeley,CO 80632
Phone: (970 )356-4000, Ext. 3750 Fax: (970)304-6497
I. Applicant Name.MIKE GOSS Phone 970-396-8772 Address 6-15 W.28"' Greeley State CO Zip 80634
2. Address or location of access 6715 W. 28th Greeley,CO 80634
Section 16 Township 5N Range 66W
Subdivision _ Block
Road #28th Side of Road NORTH Distance from nearest intersection J00 feet
3. Is there an existing access to the property? Yes X No tt of accesses 2
4. Proposed Use:
X Permanent X Residential/Agricultural U Industrial
❑ Temporary U Subdivision ❑ Commercial ❑ Other
*.k*******************************************************************************************************♦
5. Site Sketch
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Legend for Access Description: ,,
AGE= Agricultural
RES = Residential .
O&G= Oil&Gas
D.R. -- Ditch Road
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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:
.104°47'130 00"V i I 104°p7'0.00"W i• I 10.1°46'30.00"W
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'104"47'30.00"W ' 104°47'I 0.60"W 104°46'30.0O"W ^^
Name: BRACEWELL Location: 04d°23'36 0" N 104' 47' 05 0' W
Date: 8/3/2000 Captio': Mike Goss-Topographic Location Map
Scale: 1 inch equals 1000 feet
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