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2. 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
4. Date Submitted
   Date Submitted

   Date Submitted
6. Applicant Name*
   Individual or Business Name
7. Applicant Type*
   -- Select One --OwnerContractorUtility

   Indicate identity of applicant
9. Address*
11. City*
12. State*
13. Zip Code*
15. Email Address (Required)*
16. Phone Number*
18. Parcel Affected #1*
    Ex: Parcel # 123456-78901
19. Tribal Parcel
    -- Select One --NoYes

    Tribal Allotment / Parcel
21. Parcel Affected #2*
22. Parcel Type
    -- Select One --Fee ParcelTribal ParcelTribal AllotmentGovernment Parcel
24. Site Map Submittal
    Attach Site Map (pdf. jpeg. etc,) showing location of proposed utility.
Leave This Blank:


26. 1. Receive an email copy of this form.
27. Email address

    This field is not part of the form submission.

28. Submit

* indicates a required field