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<br />PERMIT APPUCATION <br /> <br />OFFICE USE ONLY <br /> <br /> <br />:,ii,:::, :":,,~:.;..'.;-'(i/ ~~:'~:-.{!i; <br />,.'....,'.i,~::._\'_;..! ,r',"-',"; <br /> <br />Expansion material required. <br /> <br /> <br />It <br /> <br />Concrete (min. 6j <br /> <br />Asphalt Base (min. 6j <br /> <br />Y N <br /> <br />Asphalt (min. 1 V2j <br /> <br />Y N <br /> <br />Length (min. 19') <br /> <br />c?.. '3> ' - <br /> <br />Width (10' mln - 20' max) <br /> <br />" ~VD' A>G ~ e.rs - <br /> <br />existing sidewalk. <br /> <br />New sidewalk. <br /> <br />( Cot.J1".1o) c1Q.)S A.~ <br /> <br />ADA compliant. <br /> <br />DP SLOE W4 .:: <br /> <br />Contiguous parking pad. <br /> <br />1",)/". <br /> <br />Triangular flare (3W x 7'L) <br /> <br />Visibility triangle o.k.? <br /> <br />N <br /> <br />Side set back (3' min. R.O.W.) <br /> <br />N <br /> <br />Plan Review Fee <br /> <br /> <br />51 <br /> <br />-L>Or C <br /> <br />Permit application approved by: <br /> <br /> <br />Date: e <br /> <br /> <br />Page 30f 3 <br />