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PERtr1IT APPLICATION <br /> OFFICE USE ONLY <br /> _� - <br /> PUBtIC Wt?RI€S 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 <br /> Width (10'min-20'max) Y N <br /> Exissting sidewalk. Y N <br /> New sidewalk. Y N .LI� E�.sS^ (. <br /> ADA compliant. Y N <br /> Expansion material required. Y N 3 � (Z � s S li�EW <br /> Contiguous parldng 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 /> �wt= 01'"walc as ddined Pub�c Waics Direc:Ear a�ui cF c <br /> Permit application approved by: Date: ` D E�.°i 3 <br /> Page 3 of 3 <br />