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<br />PERMIT APPLICATION
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<br />OFFICE USE ONLY
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<br />Concrete min. 6")
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<br />Y N M..lt..:). b(1 VJl-rHIJ,}
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<br />
<br />-WAY'
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<br />Asphalt Base (min. 6")
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<br />Y N
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<br />Asphalt (min. lV2'
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<br />Y N
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<br />Len
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<br />
<br />N
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<br />Width (10' min - 20' max)
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<br />N
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<br />Existing sidewalk.
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<br />New sidewalk.
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<br />ADA com iant
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<br />Expansion material required.
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<br />Contiguous rking pad.
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<br />Tria ular flare (3W x 71.)
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<br />Visibility triangle o.k.?
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<br />
<br />N
<br />
<br />N
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<br />Side setback (3' min. R.O.W.)
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<br />Plan Review Fee
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<br />Permit application approved by;
<br />
<br />
<br />Date:
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<br />Page 3 of 3
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