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PERMIT APPLICATION <br /> OFFICE USE ONLY <br /> PUBLIC WORKS USE ONLY <br /> Cflnaete (min. 6'� Y N <br /> Asphait Base(min. 6'� Y N <br /> Asphalt(min. lYz`� Y t3 <br /> Length(min. 19� Y N <br /> Width (10'min—20'max) 'Y IV <br /> Existing sidewalk. Y N <br /> New sidewalk. ' Y N r�. tm i�. i P l0 i�F �f <br /> ADA compliant Y N <br /> E�ansion maberial required. Y N �3 C�1� �Q i S S � �l 9.� t.�� <br /> m <br /> Co�guous paridng pad. Y N <br /> Triangular flare(3'W x 71) Y N <br /> vsibility triangle o.k,? Y N <br /> Side set badc(3'min. R.O.W.) Y N <br /> Plan Review Fee <br /> Additionat d+�a�i of work as�Sfined P'�c Woifcs Di�or and or dese n�: <br /> _-,--� <br /> �_, _ ..�. <br /> � <br /> � � <br /> � ' � <br /> Permit application approved t�r: �_ :--�- ' _. ��__ ` _, =�ate: � �E ( <br /> Page 3 of 3 <br />