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992739
APPENDIX B
WELD COUNTY ROAD ACCESS INFORMATION SHEET y�
Weld County Public Works Department Date: U/P'//7
933 North I Ith Avenue,P.O. Box 758, Greeley,CO 80632
Phone: (970)356-4000,Ext. 3750 Fax: (970)352-2868
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1. Applicant Name �R -1-ie c. i'7P1t ,F,�/ Phone 303 -le31 - 11 '' 7
Address a7AC 4pprslnncct�. F-ht.P City 6rrc; fo Statef' QZip ,g6/Q D(
2. Address or location of access o77)≤ APPi4Lm5j Atli.
Section .211 Township,,�t /N Range 4710A) r
Subdivision Grip en lfereS Block J Lot S
p Weld County Road # A Side of Road Distance from nearest intersection :2Oo 42/.
3. Is there an existing access to the property? Yes X No #of accesses 1
4. Proposed Use:
'Permanent Residential/Agricultural ❑ Industrial
❑ Temporary ❑ Subdivision ❑ Commercial ❑ Other
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5. Site Sketch
SY
Legend for Access Description: _1 P/ILOMMIO ST �i��
ARG= Agricultural w ,
RES = Residential Wilk
O&G= Oil& Gas
-- D.R. = Ditch Road b
2`.. i/Prq
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v,,�-lam sr c__________.
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OFFICE USE ONLY:
Road ADT Date Accidents Date
Road ADT Date Accidents Date
Drainage Requirement Culvert Size Length
Special Conditions
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❑ Installation authorized ❑ Information Insufficient
Reviewed By: Title:
EXHIBIT
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