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P,ERMIY APPLICATION <br /> OFFICE USE ONLY <br /> _ PUBLIC.:WORKS.:USE <br /> Concrete. (min. 6D- Y, _ . N. 46a,;{ is K, w.CTu �u RiGHT o� W. <br /> Asphalt Base(min. 6") Y N <br /> .Asphalt(min. 11/2'1 Y N . . . <br /> Length (min. AD 1' N <br /> Width(10'min-20'max) Y N lC5 ` . <br /> Existing sidewalk.. Y <br /> New.sidewalk.. Y. >: <br /> ADA compliant. Y N ►� <br /> Expansion material required. Y N Z of Viky ;O <br /> Contiguous arkin <br /> P 9 Pad. Y <br /> Triangular flare(3'W x 71) N -1&6'TL( StDE:S <br /> Visibility triangle o.V. Y) N. <br /> u <br /> Side set back(3'min..R:O.W.) Y N <br /> Plan Review Fee <br /> Additional..descri tion of-irvork as defined b' Publie WorKs Directoe,and;or desi nee: <br /> Permit application approved by: . --� . . Date: _.�Li <br /> Page 3 of 3 <br />