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l <br /> 1 I <br /> 6 <br /> °=PERMIT APPLICATION <br /> OFFICE USE ONLY <br /> " ' PUBLIC WORKS USE.ONLY ' ` � <br /> Concrete (min. 6'� Y N i <br /> Asphalt Base(min. 6'� Y N I <br /> � <br /> Asphalt(min. 1�/z'� Y N � <br /> Length (min. 19� Y N i <br /> I <br /> Width (10'min —20'max) Y N �a � � ��I <br /> I� <br /> Existing sidewalk. Y N I <br /> New sidewalk. Y N <br /> ADA compliant. Y N ,� <br /> Expansion material required. Y N <br /> Contiguous parking pad. Y N <br /> Triangular flare (31N x 7'L) Y N <br /> Visibility triangle o.k.? Y N <br /> Side set back(3'min. R.O.W.) Y N <br /> Plan Review Fee <br /> Additional descri tion of work as defined b Public Works Director and or desi nee: � <br /> a� T�ei �uG vc � .�'X 7 S/�£S <br />' � ��sP s/Z�V �NT T E !�� � ��1 <br /> Permit application approved by: Date: M 21 S <br /> Page 3 of 3 <br /> � <br />