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PERMIT APPLICATION <br /> OFFICE USE ONLY <br /> PUBLIC WORKS USE ONLY <br /> Concrete (min. 6'� Y N <br /> Asphalt Base(min. 6'� Y N <br /> U <br /> Asphalt(min. 1�/z'� Y N <br /> Length (min. 19� y N a S r _�r <br /> Width (10'min-20'max) Y N ° — �� �C�vp � � �E <br /> M �,,��a� <br /> Existing sidewalk. Y N <br /> New sidewalk. Y N <br /> ADA compliant. y N �aS � 20 <br /> Expansion material required. Y N �Tµ S( S a��jDEF•AG� C!/,eB <br /> Contiguous parking pad. Y N <br /> Triangular flare (31N x 7'L) Y N <br /> Visibility triangie o.k.? Y N <br /> Side set back(3'min. R.O.W.) Y N <br /> Plan Review Fee <br /> Additional desa�i on of woNc as defined b Public Works Direcbor and or desi nee: <br /> Permit application approved by: _ Date: l '3�v 1.� � <br /> � <br /> Page 3 of 3 <br />