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APPENDIX B
WELD COUNTY ROAD ACCESS INFORMATION SHEET
Weld County Public Works Department Date:
933 North 11th 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 Qrrae v GG> a-/L Phone 303. Lit i7136/
36/
Address G,49 _graja. `` City � : State ItO Zip PO`sr/(o
4 2. Address or location of access ( ,fresh eflat 5,2 / fiLce, CO &is/6
Section 3l Township 2 Range 6.g
Subdivision Block Lot
Weld County Road # / Side of Road Le/(o 'L Distance from nearest intersection .. 1.4izato
3. Is there an existing access to the property? Yes ✓ No #of accesses a-
4. Proposed Use: -
1 Permanent ❑ Residential/Agricultural ❑ Industrial
❑ Temporary ❑ Subdivision ❑ Commercial ❑ Other
***********************************************************************************************************
5. Site Sketch
Legend for Access Description:
ARG= Agricultural Tbty
g C R
RES = Residential
O&G= Oil&Gas c •
— D.R. = Ditch Road
1
2
4/10g•
7a
************************************
***********************************************************************
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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