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PERMIT APPLICATION <br /> OFFICE USE ONLY <br /> PUBLIC WOR1�,S U5E O1�iLY <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 <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 (31N 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 /> Additional n of wor#c as deflp+ed PuWlc WoMcs Direcbor and or ne�e: <br /> � eL 'CC 7-� �e� A ��...� i � i <br /> Permit application approved by: Date: <br /> Page 3 of 3 <br />