20070331 Permit Pkg 082407RUG-29-2007(b)ED) 10:d2
AUG-24-200? 04:37
GOP.DONS GRP.DEN CENTEP.
Yelm CDD
(FRX)360 d5~ 8427 P.002/002
360 459 3144 P.02
- Perm-r tuo: SE-07-0331 YL
City of Yelrn
P+~+~
A
~` ~ Community Developcnent Department Issue Date: 08f2412007
(Wark muat bo st~AOd wlthln 18D days)
°' Building Div191on
Receipt No:
phone: (360) 458-84C7
Fg~c: (380) CSA•314d
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'
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•
. .
Appllc~ri~ ~~ • . ~ . . - - ' . . ~ ~ ,
' '
Phone:
Namo: Konle Pet~rson
Slato: WA Z~p 98697
nddress' P.G. Box a-7
City: Yelm
PiwpettY k+ferrr~aUqn: ~ ~ • . ~ .
Sit~ Addra6s~ 308 Yolm ave. Eaat ~
Assessc~ Parc~l Ne, 99000114600
Subdivislon~
Lol;
Gonbre~to~ Iniacmad~in:. ~ ~ - ~ - ~ ~ . • . ~ . .
Contect: Phone:
Name; .
~~ry:
State: , Z~P'
Add~:
Buslness License:
CorAraClor license No;
Expires:
Pro)eat lnformatlon: . . . . , . .
Project' Gordono 6ardon Centoe
pASCription ot Wor1c' Fetl Sala SpeGlel Evoht
p (Znd) 0
Sq- Fl. pet floor. (151)
(3rd) 0
Gerage 0 Basement o
Meat Typs (Efod-Ic, Ges, Othe~:
'
~ ~eOp: ~ .
I-ern Fee . . „ •
Base Arnl Unit Fee ~ ~ .. „ •
... ~ • '
Unlt Rete No• ~~~ ~^K ~
Item ~_..-
TCTAI. FE~B: SD.00
~! ~,T ~ ^~c -s--Z ,
.L~L ' 3~~ ~,~~
~
ADAI~,~~'~avlt .~ ~ ~ ~~ ,,. - : . ~ .
I cenify thet 1 hav0 ~ad ond o~mined the In(ormatlon conWined wllhin the applicetlon and knoW the samC
~o ee erua e~a eo~.eec. i aieo csro ~~erninn~zonin~ and la a~uodlv~len~ino~ln rataluonaspleovena~~i~~t
Yelm reputatlona IncludlnB 1t1o6e g A g
easemenls and t~atrletlons of racord. N applying as a co~~~~-or, I futhar c~rtlh that 1 arn currenlly
roplitered ln tate of Washingtcn. ~~~~~~~
~
Sipnature Oete _
Flrm b , ~ . ~~ -
•OFFlC , ~' .. ~~
~
a~set's of Prin.cs: ~
f.lpal liisptol3o~; ~ ~ ,
, I]'alc: . . , , '
-8~ --- --.._ - -
~
TOTAL P.02
RUG-2d-2007(FRI) 14;15 GOPDONS GRRDEN CENTEP
~
U
(FRX)360 458 8a27 P.001/001
1/~,~f TN~ ~+,~ C x ty o f Ye l rn
; '~
Cornm~niiy Development Depariment
SPECIA,L EVENT A.~'PLICATION
~~u~ us u.kr
Y ]E L •R .~.E
~--""K•*- a. ~.w••.a
~
~M ~
NAME OF PROJECT . ~G~~ ( ~.A,P ~ . . , . - .~
APPL/CANT 0~ O vt S C~a ~~.v, -ti~-er
Mailing Address _ _ f~o f3ox4~F7 _
City, State and Zip (.I ~ I~,. ,~~ r~~~~
Telephone 3~0 ~+~a a4~~ EMAI~
OWNER e. ~r5 e
Mailing Address ~~, F3~x u~u~
City. State and Zip c,~,o l„~ f~- ~1 g~ s~7
Telephone 3foo ~s :3 .~~~ i EMAIL
S UMMARY OF REQ UES i~ ov~ ~~~ Slv e e~ ~ ~~- v~ ba~v~- n~ rs ~c~ n~
~./~Ir,,, A~~~ ni~ ~P~nc e ~ wa-I_~__=hr~- ,ol~~r~c_~~.~< r~ac~ ti 1~~, ~
PROPERI'Y DESCRIPTIC~N
General Location s~-,n Yn~-~ ~~rrp,~.+ ~ n C.~.~ (~, acros~ ~ro -,.~
~D 5 c q. v. ~ 5
Sice Address land Area (acres)
Section Township Range
Assessor's Tax Parce! Number q q oo _ ~~ ~F~, a
Full legal description of subject property (attach separale sheet if necessary)
I aK~rm Ihat all answer5, slalemenl;; and infortnalipn above and SuDm~tted with Ihis appliC~lion are Complele and
aCCUrate to Ihe Dest ol my knowlea~e_ I also affirm thal I am Ihe owner ol the suD~ecl sile or am dul~ aulho~izeG Dy
Ihe'owner ~o actwith respect lo In~~: appfiration. FunAer, I granl pennission from tne owner 1o any and all
employees ana rep-esenlatives o1 Ihe City o( Yelm and ol~et governmenlal agenCies ~o enle~ upon and insDecl
sa~d propertr as redsonably neces::ary to process Ihis appticabon_ I agrec to pay a~~ tees af Ine cily I~at apply lo
tnis applicalion.
~ %
Signe Date ~ a~`~ / D _
1os Y~1... A~~~u~ N:.~ /360) ISA.JA3f
PO Bor !i! . f3601 ISA~JJI/ FN[
Ye1n-, N'A 98Sl~ u•u•u•.cf ;vrtm.wo.u~