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<br /> :PEitMIF'APPI:YCATI�N
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<br /> ; Concreke {min. 6'� Y N
<br /> �� �Asphalt�Base(min. 6'� Y �N
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<br /> i Asphalt{min.1�/z� - -Y l�
<br /> I Length {min.�.9'� Y N
<br /> � Width (10'min—.20'max) Y N
<br /> E�c4sting sidewafk. Y N,
<br /> New sldewafk. Y N
<br /> ADA campffant. Y 1�
<br /> � Expansian materia! required. Y 1V •
<br /> Contiguous parwng pad. Y 4� �
<br /> Triangular�lare(3'W x 7'L) Y !V -
<br /> Visibtllty triangle a.k.? Y N
<br /> Side set back(3'min. 4t.0.W.) Y N
<br /> Pian Review Fee
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<br /> =CC LY.L/ttl Gaz�tl�c'� !S � ! 7_"' /2U�FI, t7l�'t YEIi/'�
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<br /> Permit appll,cation appraved.by: Date;
<br /> Pag 3 af 3
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