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P�RMIT APPI,ICATION <br /> OFFICE USE ONLY <br /> PUBLIC WORKS t)SE ONLY <br /> Cana�ete (min. 6'� Y N <br /> Asphaft Base(min. 6'� Y N <br /> AsphaR(min. i�h'� Y N <br /> Length(min. 19'} Y N <br /> Widti�(10'min—20`max) Y N <br /> E�dsting sidewaik. Y N <br /> New sideuv�alk Y N t7T+{- <br /> ADA oompliant Y N <br /> E�ansion mabe�ial required. Y N e,u 12 � S t� S I OEW L K. <br /> Cor�tiguous pariting pad. Y N <br /> Triangular flare(31N x 7'L) Y N <br /> Visibility triangle o.k.? N <br /> Side set badc(3'min. R.O.W.) Y N <br /> Plan Review Fee <br /> Addibional descri of wodc as deBnec! Pubftc Works Direc6or and or desi nee: <br /> Permit application approved by: ate: C 1 <br /> Page 3 of 3 <br />