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<br />PERMIT APPLICATION <br /> <br />. <br /> <br />OFFICE USE ONLY <br /> <br />~<iLl: c:cc:::,,!;"''f <br /> <br />:i+::i:::;::::+.l'l~::,::::::fi::,..,':.! <br />::j~:U:t,:~:!;t~:,:,o:,;-"",:",;, ." <br /> <br />...... :,~!(,';~~;;: iPUBm<<=:1WORKSj,USE~ONLY' , . <br /> <br />i'!:,,::,:;~':::::~:T::::;Y:i::"'i <br />,'-':. 't:.::L;~:i:':;:~::::i"" <br /> <br />,'iT:'!" :j:: 1: ,: ~:f: 'i: i. U <br /> <br />Concrete (min. 6'') Y N <br />Asphalt Base (min. 6'') Y N <br />Asphalt (min. 1 V2'') Y N <br />Length (min. 19') Y N <br />Width (10' min - 20' max) Y N <br />Existing sidewalk. Y N <br />New sidewalk. y N <br />ADA compliant. Y N <br />Expansion material required. Y N <br />Contiguous parking pad. Y N <br />Triangular flare (3W x 7'L) Y N <br />Visibility triangle o.k.? y N <br />Side set back (3' min. R.O.W.) y N <br />Plan Review Fee <br /> <br />i:AaClltion'ar~ClesGriDtionr:of~iwoil"~as'jCleti'nea~r!IiYBPuf:Jlia~WorlCSijDirectOtltianaljo~jaesianee: "" ':f::;;,c;:::;t! '.'_n ~i:fi:;:n< <br />C"".,.'":;:;',"; ;'T"';"'~'i:;: ;.,.,...,........ .. "',c <br />Pe rm it a p pi i cation a p proved b y: Date <br /> <br />Page 3 of 3 <br />