Form: DRR-2
CITY OF LACEY
Community Development Department
420 College Street SE
Lacey, WA 98503
(360) 491-5642
RESIDENTIAL DESIGN
REVIEW APPLICATION
Type of Project:
Single Family Duplex or Triplex Multi Family
Accessory Dwelling Unit (ADU) Townhouse
* The applicant is the person whom staff will contact regarding the application, and to whom all notices and
reports shall be sent, unless otherwise stipulated by the applicant.
OWNER NAME: ___________________________________________________________________________
MAILING ADDRESS: ______________________________________________________________________
CITY, STATE, ZIP: ________________________________________________________________________
TELEPHONE: _____________________________________________________________________________
APPLICANT NAME*: ______________________________________________________________________
MAILING ADDRESS: ______________________________________________________________________
CITY, STATE, ZIP: ________________________________________________________________________
TELEPHONE: _____________________________________________________________________________
Street Address (if unaddressed provide subdivision name, parcel number or the Cit
of Lace
Plannin
project number):
____________________________________________________________________________________________________
ASSESSOR’S TAX PARCEL NUMBER/LOT NUMBER: __________________________________________________
SUBDIVISION NAME (IF APPLICABLE): ______________________________________________________________
I/We are the owner(s) or contract purchaser(s) of the property involved in this application and the foregoing
statements and answers contained in this application are true and correct to the best of my/our knowledge.
Signed: _______________________________________________ Date: ____________________________
OFFICIAL USE ONLY
Case Number: ___________
Date Received: __________
By: ___________________
Related Case Numbers:
_______________________
_______________________
_______________________
