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PERMIT APPLICATION <br /> OFFICE USE ONLY <br /> 1-;4mb--.�,..,; . . <br /> Concrete (min6") Y N <br /> Asphalt Base(min. el Y N t <br /> Asphalt(rain. 11l2'1 - N <br /> Length_(min. 191 Y.- N - <br /> Width(10'min=20'max) N <br /> Existing sidewalk. Y N <br /> New sidewalk:- Y: . N: .. <br /> ADA cornpllant. Y .) N s t I✓w (,K <br /> BOanslon material required. Y <br /> :Contiguous parking pad. Y - . N-) <br /> Triangular flare(3'W x TL) Y N }C o.Tl Si DES <br /> Visibility triangle o.k:?. Y N <br /> Side set back(Y min. R.O.W.), N <br /> Pian.Review Fee, <br /> - � ^:�-3�� �" �� = . �;.,ar ,tom: Flint <br /> . � a:;• <br /> d itionaiazdes r s <br /> �►_d. _ -.� � t�cn:,-of;v�tork-asdefirl�e -�b. :ti,P�u�ic;�W.orlcsrDirector•�a d�orde nee. <br /> -AAO ( i 4.5 <br /> .E <br /> 0rr - lO P-wi tv miz. <br /> Permitapplication'approved by: Date: . (.. <br /> Page 3 of 3 <br />