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a 1 PERMIT APPLICATION <br /> OFFICE USE ONLY <br /> 1. _ 2:l:i:;:.t;:.:l:.<�• 177'..i•f.. _"�,..3'..�-• i'::f4if�'." ��BJ�.:i1nS ..Ro�:9i65��i;.'. <br /> Concrete (min.6-) Y N <br /> Asphalt Base(min.6") Y: N <br /> Asphalt(min..11h"). Y N <br /> Length(min. 19) <br /> . Y. N. <br /> Width(1W min—20'max) Y N <br /> Eidstlng sidewalk. Y N <br /> New sidewalk. Y N .Cc S coo'NF ao A " DO TO <br /> ADA compliant_ Y.` ' N . <br /> Expansion:material required: Y N F o Cjb5 S(DE <br /> Contiguous_parking pad. Y N <br /> Triangular flare(3'W.x TL) f Y N SI .AE 1 X-71 <br /> Vislbility triangle o:k.?. Y N <br /> Side set back(3'min.R:O.W.). . Y). N <br /> Plan Review Fee <br /> MAW <br /> MA <br /> Permit application approved by: Date: JG <br /> U-i OCA. .Csi N-b a Vo13 <br /> A,5 Page 3 of 3 <br />