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A <br /> C <br /> � '� . <br /> • p <br /> `` PERMIT APPLYCATEON <br /> OFFICE USE ONLY <br /> , .... ., , . .. ...... .. . . . . ........._. . ..,.._ _.. �. , . ,_...., . . .. . -. ,. - - � � .. - <br /> ; : , , . .. : :, ..= �. ' ��:: . � ., PUBLIC:WARKS-USE-QNLY - . , <br /> Concrete (min. 6'� Y N <br /> Asphalt Base (min. 6'� Y N ' <br /> � <br /> Asphalt(min. 1�/z'� Y N <br /> Length (min. 19� Y N 1l <br /> Width (10'min-20'max) Y N l <br /> Existing sidewalk. Y N <br />, New sidewalk. Y N <br /> ADA compliant. 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.? 1' N ' <br /> Side set back(3'min. R.O.W.) Y N <br /> Plan Review Fee <br /> ._. , .. .. . .,.. <br /> _� . ...; .:.�,. <br /> ,. .,.. ,;, <br /> _ . _ . ___ _ . �. <br /> . .. . ... <br /> �Additional_descri ,tion�.of.Awork.as=defned:b ,.Putilic.Works,Di"recfor-and�or'desi"`'riee:. ..�.. , ;�: . <br /> 5��� o E" D/rJ ,L� T <br /> !� <br /> Permit application approved by: Date: <br /> Page 3 of 3 <br />