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• <br /> PERMIT APPLICATION <br /> OFFICE USE ONLY <br /> PUBLIC WORKS USE ONLY <br /> Concrete (min. 6 ") l) N b M tN. )(Tao) R W <br /> Asphalt Base (min. 6 ") Y N <br /> Asphalt (min. 11/2") Y N �R <br /> Length (min. 19') 1100 N <br /> Width (10' min - 20' max) CY) N <br /> Existing sidewalk. Y dp <br /> New sidewalk. Y ✓ <br /> ADA compliant. Y N 04 <br /> Expansion material required. N <br /> Contiguous parking pad. N pu ?,2 (UA C P2opE2t`( <br /> Triangular flare (3'W x 7'L) (Y�) N <br /> Visibility triangle o.k.? N <br /> Side set back (3' min. R.O.W.) Y SEE D aktuA / <br /> Plan Review Fee v � A.h ?E <br /> 1 Additional description of work as defined by Public Works Director and or designee: <br /> • SET /SACK /L1 /A// 4L/ Dc ? w /7?,,v /°O,w, <br /> • Ay■NS /AV 4fA7L./A4( t` %.i V 7 ALo .6 11 / S T <br /> • 1o1,e AV/0)f 1 7lo S cL Atrr rL'��D oZS`., CegeAl, . Lot) <br /> • P/Io° ry Gr✓drE" /CoNrZf ,e 45,9004a , AneiredfrAte,ta LW,/Tt f A/yi <br /> t>T /1 /7/ LOCR . <br /> • MiYer Y 5A416 1 R( devC7 't47O USING tK /Si/it.4 Pc�V47�OAJl /ei.' S Toem 1.)4 <br /> doNvepiNtv <br /> Permit application approved by:' .erolr ! -L tr,t Date: <br /> Page 3 of 3 <br />