Snohomish County
Planning & Development Services
3000 Rockefeller Avenue, M/S 604
Everett, WA 98201-4046
*Required information.
*Development/Project Name:
________________________________________________________
*Over 50 Peak Hour Trips (PHT):
No Yes (If yes, requires Traffic Scoping Meeting)
*Attach Site Plan & Narrative:
Show: scale, north arrow, public roads, dimensions of property, lot layout and
critical areas (if known) and all access points. Briefly describe proposed project.
*Site Address or General location
(office use only: ID: ________________)
Street, city, zip code:
___________________________________________________________________
*Section/Township/Range:
S: _____ T: _____ R: _____
*Tax Parcel #(s):
List all parcels – attach a separate sheet if necessary
___________________________________________________________________
___________________________________________________________________
*Applicant:
(office use only: ID _________________)
Name: _____________________________________________________________
Firm: ______________________________________________________________
Address/City/Zip: ____________________________________________________
Phone: ____________________________________________________________
Email: _____________________________________________________________
*Representative/Contact:
(office use only: ID: ________________)
Name: _____________________________________________________________
Firm: ______________________________________________________________
Address/City/Zip: ____________________________________________________
Phone: ____________________________________________________________
Email: _____________________________________________________________
*Project Type:
Commercial _____ sq ft Office/retail/other ___________________________
CU SP Plat Rezone Site Plan Approval
Concurrent Boundary Line Adjustment Modification
Other __________________________________________________________
*Proposed # lots or multi-family units
_______
*Existing Single Family Residence(s):
_______ To be removed? Yes No
*Check one:
Urban (inside UGA) Rural (outside UGA)
*Zoning:
List county roads impacted by proposal:
*Existing Right of Way:
If r/w is noted on your site plan, attach a copy of
the document(s) used for determining the r/w
____________________________________________________________
____________________________________________________________
SCC 30.66B Traffic Pre-submittal Request
• Submit this completed form, a proposed site plan noting access, r/w documents
if noted on site plan, and a brief narrative via MyBuildingPermit.com.
• A no-cost 30.66B appointment will be
scheduled and confirmed following receipt
of above documents.
* * * * * ** * * * * * * * * ** * * * * * * * * * * * * * *
Office use only
* * * * * * ** * * * * * * * * * * * * * * * * * * * * * * *
Amand
a PFN: ________________________________________________________ Traffic staff: ___________
Appointment date: __________________ Time: __________ Confirmed: ________ Drainage staff: _________
Dated routed to R/W review: ________________ Date to TDR: ________________ TSA: __________________
Revis
ed 4/2019