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_~ ; <br />d ~ <br />~,~~~~ I <br />--~}~~ ~~VIONTROSE COUNTY <br />3?.'? South 2 Street i "` °~"°°'~" °-~°-' `°'~ <br />Montrose, CO 81401 ~:~ i" ~ `ACCESS PERMIT <br />~' x JAN 0 7 [008 <br />Phone: (970)249-6688 - <br />Fax: (970) 249-6680 ~--~--°~--~-~m~~--«---~~---..~ <br />~'~"~TRCS~ C`?iJlVT`f <br />SITE ADDRESS <br />Owner's Name: <br />Mailing Address: <br />Subdivision: <br />Contractor: <br />Applicant <br />Access Permit # <br />Building Permit # <br />Parcel # <br />Fee: <br />Received By: <br /> <br /> <br />Phone: ~ 7C cG 7~ ` '3 ~ ~~~ - <br />~~~~ ,~,kd~~~. ~, ~-~~/y' New Address Required <br />Lot Number: <br />^No <br />Phone: <br />~ ~_ / ~.r ~~ <br />'~ ~f /a ~ ~~ ~ Signature Date ~ d herein. <br />the sigCON TRSCTt NthHALlt /NOT BEGINtUNTII THE APPLICANT RECEIVES THE SIGNED GOLDENROD COPYaine <br />- - ---- Plt:.tie: -- _ ~ - _ <br />-For appointment~please contact County inspector: - - - " _ - __ _ <br />TO BE FILLED IN BY COUNTY <br />TefGGT <br />~W DRIVEWAY ^NEW ROADISTREET INTEFiStI: T IIVG ROADiS ~ n~c ~ <br />^ARerial ^Arterial <br />~clustrial/Commercial ^Collector ^Collector <br />^Residential (1, 2 or 3 Family) ^Local ^Local <br />^Field Approach <br />PLOT PLAN -Show EXISTING property lines, buildings, County Roads and driveways WITH DIMENSIONS <br />Note: Permit will not be processed without detailed s~etch provided on this form. Additional plans and specifii al <br /> <br />CMP Diameter: <br />~~ <br />CMP Length: <br />Driveway Location: <br />/ ~~~ Embedding Depth: Grade @ Road Surface: <br />Embedding Material: <br /> <br />~ ` -~;' <br />~ Sight Distance: _ / <br />/n,~p' y~ n /,. <br />J~ Access Spacing: <br /> <br />_ <br />Access Surface: <br />, <br /> Access Radii: Entering Sight Distance: <br />Access Width: <br />AccellDecel Lanes Required ? ^Yes (~~FJo Access Volume: <br />Signage Installed: ^Yes o <br />End _ <br />Evidence of legal right to access provided ^Yes ^No Scheduled Work Dates: Start <br />..^ <br />t <br />Comments: <br />/~" ~- '' ~ <br />Plans and specifications given above are approve or installation: ~ C~ ty E gme~ or Designee <br />Installed system complies with approved plans and specifications: County Inspector <br />^ADT <br />^DHV <br />d <br />Date <br />PERMIT APPROVAL: County Engineer Date <br />W WTF - rlwnnr IFinan RANARY - I an~i I lew lFinan ~ PINK - Fnninwar (Finan- (:(11 nFNR(lrl - rlwnar !(tnnetn,rtinn Annmvd~ <br />^Yes (Separate form required) <br />Lot Size: _ __ <br />nsnnm <br />