Deviation Request Application - City Of Auburn - 2016
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1
2DEVIATION REQUEST
Form last
updated on
April 2016
APPLICATION
Physical Address:
Mailing Address:
Webpage & Email:
Phone and Fax:
nd
Auburn City Hall Annex, 2
Floor
25 West Main Street
Phone: 253-931-3090
1 East Main Street
Auburn, WA 98001-4998
permitcenter@auburnwa.gov
Fax: 253-804-3114
DEVIATION FROM STANDARDS
Request to deviate from the following design elements (please check all that apply):
Design Standards:
Clearing/Grading
Water Facilities
Sanitary Sewer Facilities
Streets
Other
Surface Water Management:
Erosion & Sediment Control
Storm Facilities
Minimum Requirements
Other
Engineering Construction Standards:
Construction Standards
Standard Details
Other
PROJECT INFORMATION
Project Number
Project Name:__________________________________________ Date:___________
—
Project Address:________________________________________ Zip:____________
Related Applications
—
Parcel No(s):___________________________________________________________
—
Received
ENGINEER
Company Name:___________________________________ Phone:______________
Contact Person:_______________________________ Email:___________________
Address:_______________________ City:_____________ State:____ Zip:________
OWNER
Name:__________________________________________
Individual
Corporation
Partnership
LLC
Contact Person:_______________________________ Phone:_______________ Email:____________________
Address:_____________________________________ City:_________________ State:_____ Zip:___________
APPLICANT
Owner
Owner Agent
Contractor
Engineer
Architect
Other:
Company Name:______________________________________________________________________________
Contact Person:___________________________________ Phone:________________ Email:_______________
Address:_____________________________________ City:___________________ State:_____ Zip:_________
I certify that I have read this application and declare under penalty of perjury that the information contained herein is correct
and complete. I am either the owner of the property on this permit application or I represent the owner as signified above and
am acting with the owner’s full knowledge and consent.
Signature:____________________________ Printed Name:________________________ Date:_______________
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Parent category: Legal