Transportation - Traffic Study Submittal form

RIVERSIDE COUNTY TRANSPORTATION DEPARTMENT

TRAFFIC STUDY SUBMITTAL FORM

CASE#:	APN#:
RELATED CASES: (If Applicable): ________________________________________	FAST TRACK AUTHORIZATION: (If Applicable): ________________________________________
APPLICANT: ________________________________________ ________________________________________ ________________________________________ ________________________________________ _(____)__________________________________	APPLICANT's REPRESENTATIVE: ________________________________________ ________________________________________ ________________________________________ ________________________________________ _(____)__________________________________
TRAFFIC ENGINEER: ________________________________________ ________________________________________ ________________________________________ ________________________________________ ________________________________________ _(____)__________________________________	PROJECT NAME:___________________________ LAND USE:_______________________________ PROJECT LOCATION:_______________________ SEC(S)______TWNSP_____N/S RNGE____E/W SUP DIST:______ RD BK PG/GRID_________ THOMAS BROS PG/GRID__________________ NEAREST MAJOR INTERSECTION:________________________

FOR DEPARTMENT USE ONLY

STAFF ASSIGNED: _______________________________________

CASE NUMBER: __________________________________________

LST NUMBER: ___________________________________________

FEE RECEIPT NUMBER: ___________________________________