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1 PEE�f�[IT�PPLICIOTIOiV <br /> ` , - <br /> FFICE lJSE OI�LX <br /> PUB IC YVORKS USE ONLY � <br /> Concrete (min, 6'� Y <br /> Asphalt Base(min. 6'� Y <br /> Asphalt(min. 1�/z'� Y <br /> Length (min. 19� Y <br /> Width (10'min—20'max) Y <br /> Existing sidewalk. Y <br /> New sidewalk. Y <br /> ADA compliant. Y <br /> Expansion material required. Y <br /> Contiguous parking pad. Y <br /> Triangular flare (3'W x 7'L) Y <br /> Visibility triangle o.k.? Y N <br /> Side set back(3'min. R.O.W.) Y <br /> Plan Review Fee <br /> Additional descri �ion of wo�lc as:detined b vblic Works Director and.or desi nee: <br /> w • D• • E/2T� <br /> l <br /> Permit application approved by: Date: <br /> �Tag� 3 cg� <br />