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� <br /> , , <br /> j <br />', � PERMIT APPLICATION I <br /> � <br /> O FICE iSE ONLY <br /> . �_ ..�.. - - <br /> ,, . . _ . : : . - - - _. - . , - - , - <br /> , . �. - <br /> 1 I �. " .. . ' �., . . _ _ , C 4 - •' <br /> �.. <br /> „ P.,.U,BL _WOR�(S USE.ONLY. _ _ , <br /> ._ .. ..... . a..._ .__. . .... ,.. ... .. ., ,..,^_. ..,.. - - - <br /> - I - - - <br /> Concrete (min. 6'� Y N � <br />� I <br /> Asphalt Base (min. 6'� Y N � <br /> � <br /> Asphalt(min. 1�/z'� Y N � <br /> � ' <br /> Length (min. 19� Y N a: <br /> � <br /> � <br /> Width (10'min—20'max) Y N 22 W L�9Q�S <br /> � <br /> Existing sidewalk. Y N � <br /> � <br /> New sidewalk. Y N � <br /> � <br /> ADA compliant. Y N � �, <br /> � <br />, Expansion material required. Y N � <br /> � <br /> Contiguous parking pad. Y N � <br /> I <br /> Triangular flare (31N x 7'L) �Y N � <br /> � <br /> Visibility triangle o.k.? Y N � <br /> I <br />, Side set back(3'min. R.O.W.) Y N � <br /> � <br /> Plan Review Fee � <br /> „_ , - ._,; . ...,: . . <br /> � <br /> ;;Ad'ditional;_descri tion of�work_as�defn;ed;ti��:�ulilicrVll'orks.•Dire}ctorta�nd�or:desi'�'nee: � � ' ' <br /> - - _ . . . . . _ _ . -. .,. - - - . - -- <br /> � <br /> � <br /> � <br /> ` I <br /> � <br /> , I <br /> � <br /> � <br /> I r3 <br /> I <br /> Permit application approved by: � Date: <br /> I <br /> Page 3 of 3 <br />