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PERMIT APPLICATION <br /> OFFICE USE ONLY <br /> PUBLIC lNORKS USE ONLY <br /> Concrete (min.6'� Y N <br /> Asphalt Base (min. 6'� Y N <br /> Asphalt (min. 1�/z'� Y N <br /> Length (min. 19� Y N �— 'i To ��2oP,ii2.. L�+u�z� <br /> Width (10' min — 20' max) Y N t`— ql" <br /> Existing sidewalk. - Y N <br /> New sidewalk. Y N <br /> ADA compliant. Y N <br /> Expansion material required. N <br /> Contiguous parking pad. Y <br /> Triangular flare (3'W x 7'L) N <br /> Visibility triangte o.k.? N <br /> Side set back (3' min. R.O.W.) Y N <br /> Plan Review Fee <br /> Addidonal desc�+i n of wodt as de8ned PuWk W�ics Direcbor and or nee: <br /> • ���Sc K��P S� S� l,K •.?i-rirru P/2lYCWh ( E�Ki.l� �fr1L� t?E PE�t=ED <br /> �( Ft E�C E +tNS►c� So�N'{� �rt1a - co ° 2oss � <br /> • E bG� o P P Ew� To S�.c� �N P P�2oTE� v' �k t l UND�R <br /> oN ST�vC'[10 ►3, <br /> Permit application approved by: Date: � ( <br /> Page3of3 <br />