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20070037 SE Permit Pkg 020507City of Yelm Community Development Department Building Division Phone:(360)458-8407 Fax:(360)458-3144 Applicant: Name: Casa Mia Address: P.O. Box 1200 City: Yelm Property Jnformation: Site Address: 134 Praire Park Assessor Parcel No. 99002058849 Subdivision: Contractor Information: Name: Contact: Address: City: Contractor License No: Expires: Project Information: Project: Casa Mia Description of Work: Valentines Special Event Banner Sq. Ft. perfloor: (1st) 0 Heat Type (Electric, Gas, Other): Fees: Item TOTAL FEES: ApplicanYs Af~adavit: Permit No: SE-07-0037-YL Issue Date: Not Issued (Work must be started within 180 days) Receipt No: Phone: 400-2277 State: WA Zip 98597 Phone: State: Zip: Business License: (2nd) 0 (3rd) 0 Garage 0 Basement 0 Lot: Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc $0.00 I certify that I have read and examined the information contained within the application and know the same to be true and correct. I also certify that the proposed structure is in conformity with all applicable City of Yelm regulations including those governing zoning and land subdivision, and in addition, all covenants, easements and restrictions of record. If applying as a contractor, I futher certify that I am currently registered in the State of Washington. Signature Date 'I --- -- -- _- -- -_ _-------- Firm ------- - I B, of Prints: Feb 06 07 12:49p FEB-18-2003 00:20 Terry Cole Yelm CDD 400-3133 p.l 360 458 3144 P.02 Community Development Departrn.ent S~'ECIA.E EYEIITT A.P~LICAx''IQN \/ ~ ~ ~--~ ~-~ n -e ~~ -~ ~~r- NAME OF PROJECT , =~ - -~ ~ ~~~ -~ - ,- APPLICANT ` ' ~ ~ ~'a Mailing Address , ~-~ ~ Ciry, State and Zip - ~ ~..~ ~ `i ~_~ `~~ ~ Telephone ~ ~'~~ - a ~1 EMAlL OWNER ~~ ~ -~ Mai~ing Address ~ ~ c~ ~~ ~ ~ ~ ~ c~ ~= _ _ City, State and Zip~ ( r~ ~ t.~ ./-~ `i k~`'i `7 Telephone EMAIL SUA~lI~ARY OF RIEQUEST \-'k~ ~~ ~ ~ I ~ -~ ,~= r-.-F_~;~-~ -~ -~ ~~ PROPERTY DESCRlPTION General Location I~~-~ i~~' ~~-, ~ ~~ l~ Site Address Land Area (acres) Section Township Range Assessor's Tax Parcel Number Full legai description of subject property (attach sepa~ate sheet if necessary) I a~irm t1~at alt answers, staEemen#s end informa[ion above and submitted with this application are complete and ac~urate to the be5t of rny knowledge. I also affirm that I ern the owner of the subject site or am dufy authorixed by the owner to ect with respect to thts appllcetlon. Furtfier, I grant peRnission from the owner to any and all employees and representatives of the City of Yelm and other govemmental agencies to enter upon and inspect said property es reasonably necessary to process this appli~ation. 1 agree to pay all faes of the clty that apply to thls appltcation. Signed J L~c!~ Date '~ ~ ~~--`~ ~~- ~ l06 Yelm. Auenae Wast (860) 4b8-9896 PO Bos 479 (360) 45&9144 FAX Yelm, WA 98597 tutr~m.eLyelrre.wa.ies