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PE6tMIT APPLICATION <br /> OFFICE USE ONLY <br /> PUBLIC WORKS USE ONLY <br /> Concrete (min. 6'� Y N <br /> Asphalt Base(min. 6'� Y N <br /> � <br /> Asphalt(min. 1�/z'� Y N <br /> Length (min. 19� Y N o�L s — <br /> Width (10'min—20'max) Y N al�l � — �+ NOT to � tJJC'I.uD��.3G ), <br /> Existing sidewalk. Y N <br /> New sidewalk. Y N <br /> ADA compliant. Y N M C�2a �'c� E 2'o <br /> Expansion material required. Y N �µ S� � S►D W C,C CuL <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 descri tion of woric as deRned Public Works Direcb�r and or desi nee: <br /> Permit application approved by: Date: s JN t 3 <br /> Page 3 of 3 <br />