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20070201SE Permit Pkg 053007City of Yelm Community Development Department Building Division Phone:(360)458-8407 Fax:(360)458-3144 Applicant: Name: Freedom Wireless Address: 715 Yelm Ave. East City: Yelm Property Information: Site Address: 715 Yelm Ave E. Assessor Parcel No. 22730120102 Subdivision: Contractor Information: Name: Contact: Address: City: Contractor License No: Expires: Project Information: Project: Ballloon and Banner Description of Work: Balloon on lawn #1of 4 Sq. Ft. per floor: (1 st) 0 (2nd) 0 (3rd) 0 Permit No: SE-07-0201-YL Issue Date: 05/30/2007 (Work must be started within 180 days) Receipt No: Phone: 458-2355 State: WA Zip 98597 ~ R.~~.w. ~,,., ~ ~~;~ ~ ~. ~~ ~ ~a fi~~ = ~~~~ ~. .. Lot: Phone: State: Zip: Business License: Garage 0 Basement 0 Heat Type (Electric, Gas, Other) Fees Item Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc TOTAL FEES: $0.00 ~ App~ICaf~t~$ AffauaVlt: ._. .. ., r ~.~ ,~»,.aAil " ,r ~Io7~~~.,rrii~~~~4~GM ~~ ,~Y~'~wd~llPl'aiai ~~.ro! a i ..~t'yy,a,d'I ~.~ . .` ii ir ~u.~~.t,~..~.aW~aee~`,~:~ sm ~~.~..U~ I certify that I have read and examined the information contained within the application and know the same ' OFFICIAL USE ONLY i to be true and correct. I also certify that the proposed structure is in conformity with all applicable City of # Sets of Prints: ~ 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. Final Inspection: Signature Date Date: -- ---- - I I _ _ _ __ _-- __ - _ --- - Firm BY~ - --- I ' ----- - - - ~ ~~~~ City of Yelm ~'9~~~~°~;~~ loo~ ~/ ~t~ Community Deuelopment Department SPECIAL EVENT A.PPLICATION OFFICIAL USE ONLY YELM WASNINGTON Fee NONE ~ Date Received By # of 4 for 20 LIMITED TO 14 DAYS, 4 TIMES PER CALENDAR YEAR NAME OF PROJECT~~ M(~(~C-r ~~ (~(l.C . APPUCAN ? '' 1.~7~ ('~ ~ Mailing Address ~ ~ ~ City, State and Zip ~~ ' AlYI Z Telephone EMAIL ~ C s, " i C1G OWNER i ~ ~. CX ' Mailing Address - , 40 City, State and Zip - ~i l~~}' 2 Telephon ~ 0~ - a I EMAIL SUMMARY OF REQUEST l ~ ~1 START DATE ~ END DATE l.a PROPERTY DESGRIP ION General Location Ifl"~~fl~ (~' ~~,~~ ~ l'~(1 ~-~.Q~ i~~~3~ Site Address I~ S YYI . ~-- 5crlfi~ I Assessor's Tax Parcel Number 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. FuRher, 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 inspect said property as reasonably necessary to process this application. I agree to pay all fees of the city that apply to this application. ~ _ ~ Signe , ', Date~ I ~~~~~ ]05 Yelm Auenue Wesi (360) 458-3835 PO Box 479 (360) 958-379-1 FAX Yelm, WA 98597 mcvw.ci.yelm.wa.us