20070340 Permit Pkg 090607City of Yelm
Community Development Department
Building Division
Phone:(360)458-8407
Fax:(360)458-3144
Applicant:
Name: Casa Mia
Address: P.O. Box 1200
Property Information:
Site Address: 134 Praire Park
Permit No: SE-07-0340-YL
Issue Date: 09/06/2007
(Work must be started within 180 days)
Receipt No:
Phone: 400-2277
City: Yelm State: WA Zip 98597
u*~~: u . . .. .
Assessor Parcel No. 99002058849 Subdivision
ContractorTnformation:
Name: Contact:
Address: City:
Contractor License No: Expires:
Project Information:
Project: Casa Mia
Description of Work: Anniversary Banner
9-7-06 to 9-26-07
Sq. Ft. perfloor: (1st) 0 (2nd) 0 (3rd) 0
Heat Type (Electric, Gas, Other):
Lot:
Phone:
State: Zip:
Business License:
Garage 0
Fees:
Item Item Fee Base Amt Unit Fee Unit Rate
--------------------------- ----------- ----------- ----------- -----------
TOTAL FEES: $0.00
Basement 0
No. Units Unit Desc
ApplicanYs Affadavit:
_
I certify that I have read and examined the information contained within the application and know the same I OFFICIA~ USI
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. I~ Final Inspection:
Signature Date i Date: .
_. __- __
_ _ _ _ _ _ _ _ _ _ _-- ---
Firm ' BY:
-- ~
Sep 05 07 02:08p
~~
Terry Cole 400-3133 p.l
~"~°~ T"~ ~c,~~ C i ty o f Ye l rn
t ~ _.
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~~ Commur~ityDecelQprnent Deparfine~t
SP,~C.I,4L EVENT .APP~jCATIQ,'V
Y~LM QFF~CIAL USE ONLY
.._..K.e_
Fee__ NON
Date Rece~vec
By
~ Ot a for ?0
LIMITED TD 14 DAYS~ 4 TIMES PER CA~ENDAR YEAR
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' EMAIL
OWNER ~ ~,~ ,--, - ~ ; .,, ;
Mailing Address ----~ -; ~=~~~, ~ - "},.-'
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SUMMARY QF REQUES T
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END ~ATE - ~:
PROPERTY DESCRIPTIUN
General Location
SEt~ Address ~~ '~~--~ ~ `•- - ~ -~r,
- c
Assessors Tax Parcei Number
1 a`~~rm ihat aA answer3 Slaiemen:s an~ mformauon a~ove anC su~mme~ w~th th~s a~pl~cat~on are Co~r~~e~ea~~
acCUrate to tnp Dest pf my knowiedoe ! aI50 2Y~rm ;r,at I am ttie ov+-ner of tne sub~e~t s~ie or am qury autncrze~ ty
tne owner to ac, w~t~ r~~peCt 1o t'~~_ acpt~cat~~n Furt~ ~er, 1 orarit ~erm~ss~on frpm ;hE CN~n@r 1C any onC all
employees anC •epresentat~~es of thE Cny a! YEim and psnEr oo.•Ernmer.:al aaenues tC E:rIer ~~Or anC ~ns;E~
sa,d property a~ reaSOnaD~y r~ce5sa~y 1b Fro;,FSS thrs appl~C3tr~n ! a~ree to pzy aIl fEES ~f I~E Cfy I1~I d;p'y t~
;h~s app~~Cauan "
Signed _'4Date~
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