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PERMIT APPLICATION <br /> OFFICE USE ONLY <br /> PUBLIC WORKS USE:ONLY <br /> Concreete (min. 6'� Y N <br /> Asphalt Base(min. 6'� Y N <br /> � <br /> Asphaft(min. 1�/z� Y N <br /> Length(min. 19� Y N <br /> Width (10'min—20'max) Y N <br /> Existing sid�valk. Y N <br /> New sidewalk. Y N <br /> ADA compliant. Y N <br /> Expansion material required. Y N a) ��,v�N—' <br /> Configuous parldng pad. Y N <br /> Triangular flare(3'W x 7'L) N NOQT14 St�E � �Z�(- IU� `iF ��(3L� <br /> �sibility triangie o.k.? Y N <br /> Side set back(3'min. R.O.W.) Y N <br /> Plan Review Fee <br /> 1�d�1 _ _ ot�ra'k�s deRinad P�rbNc Wo�ks t�bor'and ar ' ' <br /> Permit application approved by: Date: � D C, l <br /> Page3of3 <br />