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` PERMIT APPLICATION <br /> OFFICE USE ONLY <br /> - - _ _ �.PUBLIC,WORKS�USE ONLY:'. - _ '. ; �;.'_ - <br /> Concrete (min.6'� Y N <br /> Asphalt Base(min.6'� Y N <br /> Asphalt(min.1�/i� Y N <br /> Length(min.19� N <br /> Width(10'min—20'max) Y N <br /> Existing sidewalk. Y <br /> New sidewalk. Y N <br /> ADA compliant. Y N <br /> Expansion material required. N <br /> Contiguous parking pad. Y <br /> Triangular flare(3'W x 7'L) N <br /> Usibility triangle o.k.? Y N <br /> Side set back(3'min.R.O.W.) Y N <br /> Plan Review Fee <br /> ..._.._... ,,....,- - - - - . .,...,-- __ _:_.. . _. ,....�r.. . . ,_ . <br /> . . _ .._ �.,..:..-;...... <br /> �:Ad`ditional_descri-#ion-of:wo'rk`as�defeed�b`:PutilicWorks•Di�ect'orandordesi nee:'=.;' ,;_. - A� -:�K-, <br /> � <br /> - b`� <br /> Permit application approved by Date: <br /> Page 3 of 3 <br />