Fillable COUNTY ROAD ACCESS APPLICATION per 13.60.040 Driveway Access/Culvert (Snohomish County)

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COUNTY ROAD ACCESS APPLICATION per 13.60.040 Driveway Access/Culvert (Snohomish County)

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  • 9 check-boxes
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County Road Access Application Rev 07/2019
SNOHOMISH COUNTY PLANNING & DEVELOPMENT SERVICES
3000 Rockefeller Ave M/S #604
Everett, WA 98201
(425) 388-3311
COUNTY ROAD ACCESS APPLICATION per 13.60.040 Driveway Access/Culvert Construction for Residential
If this application is not associated with any new/current development, please submit completed application and site
plan to SCD-.RightofWay@co.snohomish.wa.us
PLEASE TYPE OR PRINT CLEARLY
Address of Job Location Lot No. Sec. Twn. Rge. Property Tax Account Number
1. _________________________________ _____ _____ _____ _____ __________________________________
2. _________________________________ _____ _____ _____ _____ __________________________________
3. _________________________________ _____ _____ _____ _____ __________________________________
4. _________________________________ _____ _____ _____ _____ __________________________________
5. _________________________________ _____ _____ _____ _____ __________________________________
PLAT NAME _________________________________________ ZONING: ____________________________
-------------------------------------------------------------------------------------------------------------------------------------------
APPLICANT _________________________________________________________________________________________
MAILING ADDRESS __________________________________________________________________________________
CITY ___________________________ STATE _______ ZIP ____________
______________________________________________ ________________________________________________
(CONTACT PHONE NUMBER) (EMAIL ADDRESS)
Access location at public road has existing concrete curb and gutter or asphalt thickened edge
Access location at public road has existing roadside ditch or swale
Logging Access: Temporary
____ Convert to Permanent ___
Other (please specify):
NO WORK OR ACTIVITY SHALL BE STARTED WITHIN THE PUBLIC RIGHT-OF-WAY UNTIL A
PERMIT HAS BEEN GRANTED BY SNOHOMISH COUNTY.
Access permit must receive final approval prior to final approval of any related building permits.
I will accept a permit subject to the terms and conditions of Title 13 as herein set forth.
_________________________________________ ________________________
Signature Date
PERMIT NO.
____________________
____________________
____________________
____________________
____________________
SFR
DUPLEX
SECONDARY
ACCESS
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COUNTY ROAD ACCESS APPLICATION per 13.60.040 Driveway AccessCulvert (Snohomish County)

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Completed 2 May 2022

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