chromium/chrome/browser/resources/extensions/site_permissions/site_permissions_edit_permissions_dialog.html

<style include="cr-shared-style md-select">
  :host {
    --radio-group-height: 132px;
    --dialog-height: 360px;
  }

  #dialog-title {
    display: flex;
    flex-direction: column;
    gap: 8px;
  }

  #title-subtext {
    color: var(--cr-secondary-text-color);
    font-size: 81.25%; /* Default font size. */
  }

  cr-radio-group {
    padding-inline: 8px;
  }

  .site-access-list {
    max-height: var(--dialog-height);
  }

  .indented-site-access-list {
    margin-inline-start: 36px;
    max-height: calc(var(--dialog-height) - var(--radio-group-height));
  }

  .extension-row {
    --md-select-width: 180px;
    align-items: center;
    border-top: var(--cr-separator-line);
    display: flex;
    height: 32px;
    padding: 12px 0;
  }

  .extension-row:first-child {
    border-top: none;
  }

  .extension-icon {
    height: 24px;
    margin-inline-end: 12px;
    width: 24px;
  }

  .extension-name {
    flex-grow: 1;
    margin-inline-end: 12px;
    overflow: hidden;
    text-overflow: ellipsis;
    white-space: nowrap;
  }
</style>
<cr-dialog id="dialog" show-on-attach>
  <div slot="title" id="dialog-title">
    <div>$i18n{sitePermissionsEditPermissionsDialogTitle}</div>
    <div id="title-subtext">
      <span id="site">[[getSiteWithoutSubdomainSpecifier_(site)]]</span>
      <span id="includesSubdomains" hidden$="[[!matchesSubdomains_(site)]]">
        $i18n{sitePermissionsIncludesSubdomains}
      </span>
    </div>
  </div>
  <div slot="header">
    <!-- The cr-radio-group is in the header instead of the body slot so it is
         fixed in place while the list of extensions in the body slot can scroll
         if the dialog's contents exceed the max height. -->
    <template is="dom-if" if="[[!matchesSubdomains_(site)]]">
      <cr-radio-group selected="{{siteSet_}}">
        <cr-radio-button
            hidden="[[!showPermittedOption_]]"
            name="[[siteSetEnum_.USER_PERMITTED]]"
            label="[[getPermittedSiteLabel_(site)]]">
        </cr-radio-button>
        <cr-radio-button
            name="[[siteSetEnum_.USER_RESTRICTED]]"
            label="[[getRestrictedSiteLabel_(site)]]">
        </cr-radio-button>
        <cr-radio-button
            name="[[siteSetEnum_.EXTENSION_SPECIFIED]]"
            label="$i18n{editSitePermissionsCustomizePerExtension}">
        </cr-radio-button>
      </cr-radio-group>
    </template>
  </div>
  <div slot="body">
    <template is="dom-if" if="[[showExtensionSiteAccessData_(siteSet_)]]">
      <div class$="[[getDialogBodyContainerClass_(site)]]">
        <template is="dom-repeat" items="[[extensionSiteAccessData_]]">
          <div class="extension-row">
            <img class="extension-icon" src="[[item.iconUrl]]" alt="">
            <span class="extension-name">[[item.name]]</span>
            <select class="extension-host-access md-select"
                disabled="[[item.addedByPolicy]]"
                on-change="onHostAccessChange_"
                value="[[getExtensionHostAccess_(item.id, item.siteAccess)]]">
              <option value="[[hostAccessEnum_.ON_CLICK]]">
                $i18n{sitePermissionsAskOnEveryVisit}
              </option>
              <option value="[[hostAccessEnum_.ON_SPECIFIC_SITES]]">
                $i18n{sitePermissionsAlwaysOnThisSite}
              </option>
              <option value="[[hostAccessEnum_.ON_ALL_SITES]]"
                  disabled="[[!item.canRequestAllSites]]">
                $i18n{sitePermissionsAlwaysOnAllSites}
              </option>
            </select>
          </div>
        </template>
      </div>
    </template>
  </div>
  <div slot="button-container">
    <cr-button class="cancel-button" on-click="onCancelClick_">
      $i18n{cancel}
    </cr-button>
    <cr-button class="action-button" id="submit" on-click="onSubmitClick_">
      $i18n{save}
    </cr-button>
  </div>
</cr-dialog>