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. .ti <br /> PERMIT APPLICATION <br /> OFFICE USE ONLY <br /> PUBLIC WORKS USE ONLY <br /> Concrete (min.6`1 Y N <br /> Asphalt Base(min.6') Y N <br /> Asphalt(min.1T/a') Y N <br /> Length(m1n.19-) Y N <br /> Width(10'min—20'max) N <br /> I3dsting sidewalk. Y pei <br /> New sidewalk Y IV <br /> ADA compliant Y N <br /> Expanslon material mqulred. Y N <br /> Contiguous parking pad. Y iV <br /> Triangular flare(3'W x TL) 1f N <br /> VislbElty triangle o.k.? N <br /> 9de set back(3'min.R.O.W.) N <br /> Plan Review Fee <br /> AddlUonal description of work as defined by Public Woft Olrector and or desi nee: <br /> Se o of -ON S '"o <br /> c <br /> Permit applic0on approved by: Date: <br /> Page 3 of 3 ` <br />