HomeMy WebLinkAboutPre-Application Meeting Request Form(—IINATEDINA
Today's Date:
Pre -Application Meeting Request Form
501 Evergreen Point Road, Medina, WA 98039
(425) 233-6414 / www.medina-wa.gov
Preferred Pre -Application Meeting Date (Wednesdays):
Preferred Pre -Application Meeting Time (select one): 8:30am 9:30am 10:30am
Pre -application meetings are conducted on Wednesday mornings. Please submit this form along with a
PDRElectronic version of your preliminary project plans and other documents to our Permitting Portal by 12pm
on the Thursday before your preferred pre -application meeting date.
Applicant Contact Information
Contact Name and Title:
Phone:
Mailing Address:
Alternate Phone:
City: State: Zip:
Email:
Property Information
Parcel Number:
Project Address:
Property Owner's Name:
Briefly describe proposed project:
Rev. January 9, 2024