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APPENDIX B
WELD COUNTY ROAD ACCESS INFORMATION SHEET
Weld County Public Works Department Date: 1 'L. C>
933 North 11th Avenue, P.O. Box 758, Greeley, CO 80632
Phone: (970)356-4000,Ext. 3750 Fax: (970)352-2868
I. Applicant Name_ f\ NI n-kt v y N P J R,'LWU Phone '69-3 —(1(4.(A
Address -709 43vt0 Pcu1 _City (S,24 .C- ' State (' o Zip &6L54
2. Address or location of access 2.2 4 a is 24 DA 5's- t,2ti zLE y . CO gt'i. i
Section 15 _ Township 5 n1 Range (436vJ
Subdivision Block Lot
Weld County Road # I PIS,- Side of Road R Distance from nearest intersection V z .-. , Lr£
3. Is there an existing access to the property? Yes '/-. No_ # of accesses I
4. Proposed Use:
❑ Permanent ❑ Residential/Agricultural Industrial
❑ Temporary ❑ Subdivision , Commercial ❑ Other
5. Site Sketch
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/
Legend for Access Description: a f
c`i7N sr
(ARG Agricultural \( ) ( L_ �
RES = Residential l Wide
O&G= Oil& Gas /1, i�,
DR. = Ditch Road
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1
7 7
************************************
***********************************************************************
OFFICE USE ONLY:
Road ADT Date _ Accidents _ Date_
Road ADT Date _ Accidents Date
Drainage Requirement Culvert Size Length
Special Conditions
***********************************************************************************************************
U Installation authorized ❑ Information Insufficient
Reviewed By: Title:
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