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5 ldentify the accessrbrlrty Features and equrvalent facrlrtres that W!!lt be brought rnto comptrance wrth the <br />latest editlonof Title24 asa partof thrsprolect andanestrmateof thecost ofeach rtenl (DocuDEnta/ia/)/ ay be requ//e(/l <br />Accossible Featuros to bo Mado AccosBlblo Cost of lmprovomont <br />a Enlrance <br />E Door D Landrng ! Stairway/Steps D Ramp ) <br />b Path of Travel <br />D Path of travel from accessrble parkrng to lhe burlding entrance sand area of remodel <br />Path of travel to sanrtary Facrlitres / pubtrc phone i dr ink rng <br />founlarn <br />E Path of travel from the publrc way to the burldrng entrance ) <br />c. Sanitary faciljties (Floor no S <br />d Public phone(s) <br />e Dflnkrng fountarn(s)5 <br />f Parking J <br />g Srgnage & Alarms $ 210 <br />i Olher ) <br />Tot l: S <br />ldentrfy the accessrbrlrty Features that wlLL ilor comply if a requesl for unreasonable hardshrp rs <br />granted Provrde an eslimated cost of compliance for each item (Docunrc/tlahon nzy be reqt/lred) <br />Acc6sslblo Featuros llot to bo lmprovod Cost of lmprovemont <br />a tl-:we a-ah+ig,/L-$ jir:ooD - <br />b <br />C <br />Total:s ?t0 ooo <br />8. Potltloner must be the legal property owner or hle/her legal reprerentaUvo: <br />icertify lhat the above noted rnformalion is kue and correct <br />E Legal Property Owner ! ArchitecvEngineer ! Contractor p.Other LDr'!t\, wlCll- <br />Pflnt Nan]e <br />--r_ -- - ^-J€ fi- t\€-fiOdvJ Phone No ?r I ?zz-71ao <br />Address <br />Srg nature <br />@ iA!Lg>r,,t f r+a) co+ttt h€5A ta ltatt <br />Date 2l <br />Approved by <br />l?cv t)ztt)4l2A2O <br />FOR AGENCY USE ONLY <br />Date <br />Page 2 o12 <br />-l <br />i <br />I <br />-t <br />I <br />l$ <br />1s I <br />I