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. , <br /> ' PE+RMIT APPLICATION li <br /> OFFICE USE ONLY <br /> _, - - - <br /> . , ;. ,,-,- _ _,: - ., . - _ - _ . � . . <br /> ,. .; ;_- ,.-�. ,�, . , ; , .,. - `�. :, - _ - _. - _- _ - - - <br /> , .. , _ .... ._. _ .. <br /> .. . .. _ _. � <br /> ,:. . . .: <br /> . . ._•;.�..,,; _ PUBLI,C WORKS;"USE-ONLY:z;" �:.� --., . .. : : : <br /> Concrete (min. 6'� Y N <br /> Asphalt Base (min. 6'� Y N <br /> Asphalt(min. 1�/z'� Y N <br /> Length (min. 19� Y N a( � <br /> Width (10'min—20'max) N � � <br /> Existing sidewalk. Y N <br /> New sidewalk. Y N <br /> ADA compliant. Y N <br /> Expansion material required. Y N E S(�'�C6F �JO(E � <br /> Contiguous parking pad. Y N <br /> Triangular flare (31N x 7'L) Y N S�E SK�'tG44 IJOT�C , <br /> Visibility triangle o.k.? Y IV <br /> Side set back(3'min. R.O.W.) Y N <br /> Plan Review Fee <br /> __. . .._.... .. _ ... .... ... .........::.:...: . ..._:.... .:..:-.:.,; .-- -. - _. .. . . <br /> .._ .,_. _ ,._. <br /> 'Additional'descri tion:of-workas�defined:ti :Pu61ic`;Works`Director.an�i�or:des�'riee:�- `��s;=...:;-•��=�`°�.�'" ,;�;-,�` ,�--= <br /> c <br /> Permit application approved by: Date: 22.Sv��� <br /> Page 3 of 3 <br />