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2. General Information
4. Land Owners Name:*
5. Phone*
7. Contact Person*
8. Phone*
10. E-mail Address:*
11. Today's Date:*
    Today's Date:
13. Landowner Mailing Address:*
14. City:*
17. State:*
    -- Select One --WAALAKAZARCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWVWIWY
18. Zip:*
20. Street Address Where the Vehicle is Located:*
21. City:*
    -- Select One --ArlingtonBothellBrierDarringtonEdmondsEverettGold BarGranite FallsIndexLake StevensLynnwoodMarysvilleMill CreekMonroeMountlake TerraceMukilteoSnohomishStanwoodSultanWoodwayWoodinville
23. Zip Code*
25. May a Snohomish County Junk Vehicle Investigator access your property while you are not present?*
    -- Select One --YesNo
27. Vehicle 1
29. License Plate Number:
30. State:
32. Year:
33. Color:
35. Make:
36. Vehicle Identification Number:
38. Comments or Additional Information
40. Vehicle 2
42. License Plate Number:
43. State:
45. Year:
46. Color:
48. Make:
49. Vehicle Identification Number:
51. Comments or Additional Information
53. Vehicle 3
55. License Plate Number:
56. State:
58. Year:
59. Color:
61. Make:
62. Vehicle Identification Number:
64. Comments or Additional Information
66. Vehicle 4
68. License Plate Number:
69. State:
71. Year:
72. Color:
74. Make:
75. Vehicle Identification Number:
77. Comments or Additional Information
79. Comments, Directions or Additional Information
81. If you have any questions, or additional information, please contact the ECUP team at (425) 388-7613.
Leave This Blank:


83. 1. Receive an email copy of this form.
84. Email address

    This field is not part of the form submission.

85. Submit

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