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APPENDIX B <br />WELD COUNTY ROAD ACCESS INFORMATION SHEET <br />Weld County Public Works Department Date; t? OS 65 <br />I i 1 I H Street, P.0. Box 758, Greeley, CO 80632 <br />Phone: (970 )356-4000, Ext. 3750 Fax: (970) 304-6497 <br />I. Applicant Name Weld County Public Works Phone (970)304-6497 <br />Address 1111 H Street, P.O. Box 758City Greeley State CO Zip 80632 <br />2. Address or location of access Ashbaugh Pit, WCR 115, 1/2 mile North of t-ICR 80 <br />Section 15 Township 7 Nortlr Range 59 West. <br />Subdivision Block Lot <br />Weld County Road # 115 Side of Road East Distance from nearest intersection 1 2 mile <br />3. Is there an existing access to the property? Yes _~ No _ # of accesses 1 <br />4. Proposed Use <br />^ Permanent ^ ResidentiaUAgricultural ^ Industrial <br />8X Temporary ^ Subdivision ^ Commercial D Other gravel pit <br />######w###wi###########w######ww#w##www##ww##w##ww###w####w########w#####w######i#######w###w#### <br />5. Site Sketch (~~ <br />Legend for Access <br />Description• ~ ~ =r <br />~ 4~t{" <br />AG = Agriculrural <br />RES =Residential <br />O&G = Oil & Gas <br />D.R. =Ditch Road <br />####w##w#w##ww#www### <br />OFFICE USE ONLY: <br />Road ADT <br />Road ADT <br />Drainage Requirement <br />Special Conditions <br />~ ~. <br /> <br />_ Date Accidents Date <br />Date Accidents Date <br />Culvert Size Length <br />#####wwww####w####ww#w#ww##www####w##w##w##w###w######*########################r#*###w####ww#ww## <br />^ Installation authorized O Information Insufficient <br />Reviewed <br />Title: <br />9 <br />