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Franchise Application Form
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Yakima County Franchise Request From
This is where I would add text explaining who, what, where, why and how the applicant needs a franchise application
Date Submitted
Date Submitted
Date Submitted
Applicant Name
*
Individual or Business Name
Applicant Type
*
-- Select One --
Owner
Contractor
Utility
Indicate identity of applicant
Address
*
City
*
State
*
Zip Code
*
Email Address (Required)
*
Phone Number
*
Parcel Affected #1
*
Ex: Parcel # 123456-78901
Tribal Parcel
-- Select One --
No
Yes
Tribal Allotment / Parcel
Parcel Affected #2
*
Parcel Type
-- Select One --
Fee Parcel
Tribal Parcel
Tribal Allotment
Government Parcel
Site Map Submittal
Attach Site Map (pdf. jpeg. etc,) showing location of proposed utility.
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