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PERMIT APPLICATION <br /> OFFICE USE ONLY <br /> PUBLIC;WQRKS USE ONLY, <br /> Concrete (min. 6'D Y N <br /> Asphalt Base (min. 6') Y N <br /> Asphalt(min. 1 1I7') Y N <br /> Length (min. 191 Y N <br /> Width (10'min—20'max) rY ' N <br /> Existing sidewalk. Y N <br /> New sidewalk. Y N <br /> ADA compliant. Y N U E} <br /> Expansion material required. Y N iv <br /> Contiguous parking pad. Y N <br /> t; <br /> Triangular flare(3W x 71) Y <br /> Visibility triangle o.k.? Y N <br /> Side set back(3'min. it.O.W.) Y N <br /> Plan Review Fee <br /> AdditionAl ttescri`#ian of work as defined PubLjc Works Director and cr desi ee: <br /> Permit application approved by: .2 3 I-4A)I <br /> Page 3 of 3 <br /> j <br /> i <br />