20070264 Permit Pkg 071107~~pf THFP~ City of Yelm
~ ~~ Community Development Department
~ a ~+
Building Division
Phone: (360) 45&8407
_, Fax: (360) 458-314d
Applicant:
Name: Lawrence, Lisa
Address: P.O. Box 1166
Property Information:
Site Address: Yelm City Park
Assessor Parcel No.
Permit No: SE-07-0264-YL
Issue Date: 07t11/2007
(Work must be started within 180 days)
Receipt No:
Phone: 253-720-5105
City: Yelm State: WA Zip 98597
Subdivision:
Contractor Information:
Name: Contact:
Address: City:
Contractor License No: Expires:
Project Information:
Project: American Cancer Society Fund Raiser
Description of Work: Fund Raiser in the City Park
~ Sq. Ft. perfloor: (1st) 0
Heat Type (Electric, Gas, Other):
Fees:
Item
TOTAL FEES:
Applicant's Affadavit:
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 ali applicable City of
Yelm regulations inciuding 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 curcently
registered in the State of Washington.
Signature ~i~~~ (G~~~~~Qn ~ Date ~~, a(~(J 7
Firm
(2nd) 0 (3rd) 0 Garage 0
Lot:
Phone:
State: Zip:
Business License:
Basement 0
Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc
$0.00
# Sets of Prints:
inal Inspection:
Date: __~__
BY~ -------
~ ~
Community Deuelopment Department
SPECIAL EVENT / TEMPORAR Y USE
APPLICATION
Special Event Sign Permit (~imited to ~a days, 4 times per calendar year)
TempOt'aty Use (property owner permission letter required)
(see REVERSE for regulations)
NAME OF PROJECT /' ~ ~ a ~" ~ '/ ~~ X'!~~ •- ~ ~' ~ <<~ i~ ~ ~ ' ~ ~~
APPUCANT/BUS~ESS NAME l5~? ~ ~~-~ nC~
Mailing Address . ~ . ~`
~ ~ - ~„
City, State and Zip
Telephone ~,~~'', ~~ `7~C~ -_ -~, I'c~~ EMAIL ~r~ ~5~~ r~-~ ~r.~~:>rKt~ ~~ l~'~~
City of Yelm Bus~ License Number ~
SITE OWNER L_ ^ r
Mailing Address
City, State and Zip
Telephone EMAIL~
SITE ADDRESS/LOCATION tl ~ ~ ~
SITE PARCEL NUMBER
SUIV~MAI~y OF REQjUEST '~ ` ~ ~ c ~ ~ % ~ ~3~~
~~ c< L' C' ,L.c'L~ C" J - C;l t:~ ~' ~ r~
START DATE ' - - C~ END DATE ~- I~-Z
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 inspect
said property a easonably ecessary to process this application.
Signed ~ n Date ~~ ~" ~^~~
ROUTING: SPECIAL EVENT Building Section
TEMPORARY USE ~ Planning Section Building Section
105 Yelm Avenue West
PO Box 479
Yelm, WA 98597
(360) 458-3835
(360) 458-3144 FAX
www.ci.yelm.wa.us
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