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� PERMIT APPIICATION <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 � s � <br /> Width (10'min—20'max) N � <br /> Existing sidewalk. Y N <br /> New sidewalk. Y N <br /> ADA compliant. Y N +� <br /> Expansion material required. Y N <br /> Contiguous parking pad. Y N <br /> Triangular fla�e (3'W x 7'L) Y N <br /> Visibility triangle o.k.? N <br /> Side set back(3'min. R.O.W.) Y N <br /> Plan Review Fee <br /> Addltional desa�i tion of work as defined b Public WoMcs Director and or desi nee: <br /> E�e L'aN�itio �t/ 0 S,eETC� — <br /> Permit application approved by: Date: <br /> Page 3 of 3 <br />