Applications and OriginalsCity of Yelm
Community Development Department
Building Division
Phone: (380)458-8407
Fax: (360)458-3144
APpflcarrt:
Name: Brock, Jeri Lynn
Address: 14538 McIntosh Lane SE City: Tenino
Permit Fees Schedule
Permit No: SPR-05-0492-YL
Phone: 380.448.1769
State: WA Zip 98589
Project Information:
Project: Brock Offices
Description of Work: Change of use from residential to commercial offices
Site Address: 211 Yelm Avenue West Assessor Parcel No. 85800300400
Fees:
Item Acct Code Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc
Site Plan Review - 001-345-81-00 450.00 350.00 100.00 0.0500 2,000.0000 Square Foot
Comm.
TOTAL FEES: :450.00
a~°f T„~ CITY OF
YELM
P.O. Box 479
Yelm, WA 98597
360-458-8403
RECEIVED +~++•*FOUR HUNDRED FIFTY DOLLARS & 00 CENTS
RECEIVED FROM DATE REC. NO.
JERI LYNN BROCK 03/09/06 41080
14538 HCINTOSH LN 3E
TENI>g0. KA. 98589 BUDGE?ARY
PP~°
i~~~`
MP~~~
OF ~E~M
G~~
RECEIPT No. 410 8 0
AMOUNT REF. NO.
450.00 CHECK 2871
JANINE
SITE PLN REV SPR-05-0492-YL
SITE ADDRESS 211 YELH AVE W
Date Re
City of Yelm rGe
ey
File No.
Community Development
Department
SITE PLAN REVIEW
Site Plan Fee:
Mobile Home Parks: $250.00 plus $50.00 per mobile home space
Multi-Family Building/Condominium: $350.00 plus $50.00 per unit
Commercial Site Plan: $350.00 plus $50.00 per 1000 sq. ft of gross floor area
Industrial Site Plan: $350.00 plus $150 per acre
(In addition, any professional service charges per Resolution #358)
Site plan review is a process for reviewing the design of certain types of development.
Site plan approval is required for mobile home parks, duplexes, multi-family dwellings,
commercial and industrial uses, planned development districts and for all land uses
within the central business district.
NAME OF PROJECT G~RGC~~ ~ ~G~S
APPLICANT L M ~' S S
Mailing Address 1538 IM,~T...,~s ~ l~N ~~
City, State and Zip r4
Telephone ~/- ( ~ EMAIL Z~7' G~~P~
OWNER o~ ~ ~ S
Mailing Address ~e~ ~ ~D
City, State and Zip NI O 58" ~~
Telephone - EMAIL
S 53 - 88
ENGINEER/ARCHITECT/OTHER -t
Mailing Address
City, State and Zip
Telephone EMAIL
SUMMARY OF REQUEST
-~
PROPERTY DESCRIPTION
Gen ral Location 2, l l ~f~ ~ ,n~. Fk JE L~
~~tw. ~ ~s
Site Address Land Area (acres)
Section Township Range
Assessor's Tax Parcel Number 00
Full legal descn tion of subject property (attach separate sheet if necessary)
Y Iw- L~ ~3 -S E %_
a4 t ~l -~/ ~,.,
,~c-
1 ~~' ~~~'~ ~~
~~ ( ~
'~'-'I
105 Yelm Avenue West (360) 458-3835
PO Box 479 (360) 458-3144 FAX
Yelm, WA 98597 www.ci.yelm.wa.us
PLEASE ANSWER THE FOLLOWING QUESTIONS
ATTACH EXTRA PAGES IF NECESSARY
1. Does the design minimize conflicts with ~ ighboring land ~
or `+~~s.C~+Kn~/
2. Is the site within 300 feet of any "critical areas" such as wetlands or streams?
I~1D
3. What provisions will be made for storm water and/or flood control?
c~,raiNAcE rn~ Oar~tNG lod-
4. What rovisions will be made for water supply and sewage disposal?
~~ S~ S~GvwS
5. What provisions will b made for elec~fical power natural gas, to(el~h r?e
and other utilities? ~ ~ Il u-~~ t~~ 1~~
Axe rM. I Ab ~ ~ ~ t c. f CDIti/t
D~mnL
6. What provisions will be ~1ade for streets, access, and/or buses? Ar(l
7. What provisions, ifan~y,,~rill be made for open space and/or recreation?_
~d1, ~ a..(~a
8. What provisions will be made for schools and school children?
I affirm that all answers, statements and information above and submitted with this
,application are complete and accurate to the best of my knowledge. I also affirm that I
am the owner of the subject site or am duly authorized by the owner to act with
respect to this application. Further, I grant permission from the owner to any and all
employees and representatives of the City of Yelm and other governmental agencies
to enter upon and ' ect said property as reasonably necessary to process this
application. I ree o pay all fees oft~ISe city that apply to this application.
105 Ye[m Avenue West (360) 458-3835
PO Box 479 (360) 458-3144 FAX
Yelm, WA 98597 www.ci.yelm.wa.us
L% ~'"~' CHECKLIST
PLANNER USE ONLY
Checked by_Date
Submitted Missin
ATTACHMENTS:
* Eight copies of Site Plan at a scale not less than
one inch for fifty feet, showing:
~/I' Datum, north arrow, date and scale.
,~ Vicinity map showing nearby property,
streets, land uses, streams and other features.
The location of all existing and proposed
structures, including, but not limited to, buildings,
fences, culverts, bridges, roads and streets
on the subject property.
4. Wells and underground storage tanks within
200' of property. 1~~'~7
~Sr. The boundaries of the property proposed to
be developed.
~ All proposed and existing buildings and
setback lines.
7. All areas, if any, to be preserved as buffers or to be
' dedicated to a public, private or community use or
~~.~~~ for open space under the provisions of this or any
other city ordinance, information regarding percentage
of area covered, locations and general types
of landscaping.
All existing and proposed easements.
,~8~ The locations of all existing and proposed utility
(~
~ ~, structures and lines.
~:~_.L Ba.. -
~ --- 10. A preliminary storm water drainage systems
~,..~- y~~w•- ~c-~ layout for existing and proposed structures.
vYl. All means of vehicular and pedestrian ingress and
egress at the site and the size and location
of driveways, streets, and roads.
The location and design of off-street parking
areas showing their size and locations of
internal circulation and parking spaces.
13. The location of all loading spaces, including,
but not limited to, tr ck loading platforms and
~~j9,/3~ ~ loading docks. ~
14 Location and area, in square feet, of all signs.
~~~- 15. Topographic map or maps which delineate
(p/ contours, both existing and proposed, at intervals
of two feet, and which locate existing lakes,nh~
streams and forested areas, (or 5 foot if > 5%).
16. Grading plan for cuts and fills over 100
_cubic.yards. _,~__ . _._____...
A reduced size copy of the site plan nott lar
than 11"X17". ---
* ree and Vegetation Preservation Plan
per section 14.16.110 (if applicable).
* 2 copies Design Guidelines Check-list.
* 2 copies Conceptual Landscape Plan.
* 2 copies Traffic Impact Analysis (if applicable).
* 3 copies Storm Water and Drainage Report.
* 5 copies Environmental Checklist (including $150 fee)
* Mail labels (8'/2 X 11 sheet) of Owners of Property
within 300 feet (include Assessor's Tax Parcel
Numbers and map).
* Copy of any covenants or restrictions that will apply.
105 Yelm Avenue West (360) 958-3835
PO Box 979 (360) 458-3199 FAX
Yelm, WA 98597 www.ci.yelm.wa.us
i+~ , PIF t t+, l~li,
1UT11,iTY EASEMCNT '~'~ '..~:~'~'~+ ~+ui}IT~~1?
„_..,__~.,,HF~SL.Lb._Mf..SQ1lD0EN ~ -.j:..:~.__._ _„:, tcrejnaftcr
referred w rs "rJwner," is the owner of the property legally dcsrrihed as: _...~.. __..__------..----_
Thc parties hereby authorize Parametrix to Insert rner their signature the correct legal desrripti~n of the atxtve de-
scritxdproperty if nnavailah4e at the time of signing, ar tnit[rrect the irgal desrriptinn entered if ernmcuus ar incomplete.
Tt+c address of such property is: ? 1, l YE.4M_.BY.E ~ •--•---
Owner grants to the City of Yelrn its successors and assigns an easement over, under ant) acr+ns thr aho~:e described
property for the purposes of constructing, tea±ntnining, repairing, aUering or reconstructing a sanhary sewer collection
system. The system shall consist of gravity clean-out, side sower from the septic tank to the gravity rfean•out, septic
tank, pumping system, electrical conduit aril cable, cttntml panel, fitrec main, service box and related appurtenances,
Thc C try of Yelm wiq he responsihlc to pump the scptk tank wtun requited. The Owner wilt hear tilt cost of the elec-
trtcity and replace any caisting side sewer from the tank if found defetaive.
This eascmr.nt ix fur the benefit of all properties now w hecrtfler served by the sanitary sewer system. of the City.
Thc City at Yelm and the Owner concur and agree that ronstntcting, repairing, altering or reconstructing of said
sewer improvements by the City uF Yelm shat{ he accomplished in such a manner tt>at the private improvements ex-
isting an this described parcel ut'real properly shaft he disturbed to the Icttst extent possible. In the event they art: dis-
ntrtxd or destroyed, to dte extent reasonably passible, they will do replaced inns good a rnnditinn as they were immelfatcly
txfore the property was entered upon by the Chy of Yetm.
Thc Chy of Yclm and the Owner agree that the Owner shell undenake na nltcraNon of the installed sewer system(s),
including covering or obstructing access to pump basin eicattouts and the lockout switch, withtntt the prior written a{.-
proval of the City of Yetm. Any damage caused by the Owner or their agents shalt he repaired by the Ciry of Yelm
nt the Owner's expense,
Owner agrees and undcrstandx that this ersement wi4 he recanted with the Gottnty Atulltor anti will he binding upon
heirs, successors and assigns of Owner.
Owner and Clty agree that the Owner has incurred no displacement rusts nr relocation costs by virtue of the Agreemetn.
The City agrees to furnish, install, operate anti maintain the pump system In a reasonable condition anti to da the work
in a workmanlike manner, promptly, neatly and with u little Interference to the real property and imprm'ements thrre-
on of Owner ns rcasonahly prartirablc. Ownership of the STEP system on the described pnrcei of real pn+peny shall
remain with the City of 1'elm.
DataS this .-_~L~day of ~,~d~_, 19~,,~.
OWNER ~~ C[T1' OF YELM
AOEiNT OR CITY OF YELM
(PARAMETRTX, JNC,l
S7ATE OF WA53{1NGTON
sS.
COUNTY OF Tt[URSTON
On dtts day personalty appeared fxfnrc me ~~-''~ /1M l~~,~t,~7CI~a~~~tL~i°_...a..'~._ ant! who
caccutcd the wid+in and tittcgoing instn+mcnt as "Owner" and xknowlcdgctl dwt trcJ%I recd tttc satnc as 1tisAtotQ31F•iCt'~L
fret anc+ vnlunlary au and decd firr the msros and pttrptxus therein mrntirmed.
Given under my hand and official scat thh, .~.~ dny of ~ I9_..~..~.
NOTA ' P R n arxL rt>f ttte State of Wasltin~tcm, residing
No oz-4oeo
Nano: NEVIN MCSPADDEN
Address: P • O. [30X 79 ~~_
YELM, WA, z;p 985Q7
Plan Sttect Ne.:
THURSTON COUNTY
TAX PARCEL NO.
H'tp00'100400
City of Ycfnt
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L~ ~ rw'C~~i~--
Rc>Z+crt A. iri M.a`y'~r
~,~ belly A. l3adycr, Ciry Clerk
APPROVED A5 TO FORM
Yclnt Ciry Anonrey
VVhrti rapr - Ctty of Yttm Gn~ry o~+y •- City of Yekn PInM oep- - Arop~ny Owner Goldenrod copy - Ttk
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Preporcd By pisnt: ReMSions:
DR. BROCK
~ ~ i ~ ProXct nne: TECHNICAL SERNCES, Me. 718 YELM AVE. WEST
~ $ $
OFFICE REMODEL na Euc ate aw. 017mp0e, • tae601 YELM, WA
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