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20070365 Permit Pkg 100107I ~ OCT-Oa-2007(THU) 08:51 GOPDONS GARDEN CENTEP OCT-01-2007 00:6d Yolm CDD ~ c *~ City of Yelm ~ ~ Community Dovoiopmont Ovp~rCm4nt 4 Buildinp Division Phone: (360) d58-8407 Faa: ~~oo) 4aaa~as AtPPIQcartt; ~ , ' , -' , ' . Namo: . . Kollio Potereon Addreor: P.O. B4x 447 Proper~r InfnrmaUon: '; . ~ Site Addre99: 30B Yslm ars. Eeae A650s6or Par~el No. 990AO~ 14AOo C04lnlota ~ ~I n~pmlat(Ori: . N9me: Aedreaa: Conuac~or ~Ireno~ No: P n0 jq Ct ~I nfpl7nabon : Proiect Gordons Garden Cencer ~occrlpllo~ of WOtk; CJeo Cash Rodqmppon Sq. Ft. perfloor. (1aq o (2nd) ~ Heet Type (E~ecv~c, oe~, o-ne~: Clty: Yelm 6ubdlvlslon: Contact: ciry: ExP~rrs' (3rd) 0 GeraOe 0 ~eee. , . . . . Item Item Fw Booo Amt Unit Foo Unit Rete TOTA[. FE~S: SO.Oo ~~o a5e 3166 P.02 Perm-t No: SE-07~0365 YL Issue Date: 1 0101 12 0 0y (Work mu6t DE 9terted wtthln 180 days) R~cGlpt No: Phone: ~mto: wA zlp 89597 LOG Phorte: Stete: Zlp: Buslneas Lfranse~ Hasgment 0 No. Units Unl( DesC App~tca~rit'o ~-ffadavit: I ~ I oortily thot t hove read and examined the Informatlon cpntalned wllhln lne appllr,etlon ane knaw ths aame p~~~~~'~~~~~Y .. tn bn tlu0 oAd oorrac[. 1 a1gD Celt~y lhet the proDOSEd Stl'uClure la In ee~ortnlry wlth ell applltsble Clfy o/ q.8e1ypFPdndr,~,,,r . Yvlm repulatbns InetudlnA teose governing zoning end land ~uDcllvL,lon, ane In addlelon, el~ eovonanla, . • p~m•ntr and rosMCtlon6 of reCOrd. If applying as a conlractor, 1/uther cartlry that 1 am aur-ently ;~~ =';~: • , roglctorod in the State of Washfnpton_ p~~~ j~~~ppy '- ~~ . .. ' ~ Qase•~ Sipnafur _ pota ~a ~~ /a: 7 , Firm -- C '"~1..L,_,CI.C!'ni~ .. ..fir'~Ptc/ ---- ey. •----- ~-- .._~~. TOTAL P.02 (FAk)360 458 8d27 P.001 5EP-26-2007(bIED) 15: ~0 GOP.DONS GAP,DEN CENTEP (FAk)360 d58 8427 P.001 ~/~,~f THF~~~ C~ ty O f~r'e l7rL : '~ Community Developmeni Depor~ment SPL CI~L EVENT APPLI CATION q~ii~~ usE Or• Y E L M '» -~^~ ~.~r.rc~s~r O~r R~cw..a a ~t ~+o ~ ~ . . , ._ . :. . ~ . . , . . . . . . . . . . .... . , ~ . . . NAME OF PROJECY ,0 ~ 6~~ ~ W APPLICAN7 ' Mailing Address ~~ u y y 1 City, State and Zip LI ~. w~ ~ ~,LJ 1~ ~I 5~ 1 Telephone ~l~o ~f-5~. a.4~ I ~ EMAIL OWNER , ~. ~ Mailing Address ~I City, State and Zip ' ~A ~'~ S~t `~ Telephone '~U b~F5~ a~ S~ I ~ EMAI~ SUMMARYOI~ REQUES i~ . ~ _ 1.1.) f.~ '~ C'. ~ ~ ~ 0 - l_ ) " Q. 1.. N I PROP~RTY DESCRlPTIC~N General Location ~~' ~ ~ ~ ~ ~'l.~-~-~ ,~ ~ ` ~. Sice Address 4-oR ue.t,,~, A~~ F Land Area {acres) Section Township Range Assessor's Tax Parcel Number ~~ o001 I~~a Full legal description o1 subject property (attach separate sheet if necessary) I affirtn tha~ all an5wer5, slatement~; and inlortnalion 2DO~E a~d submifled wilh IhiS appliCalipn are complele dnd accurate lo Ihe Desl ol my knowled~e. I a~so atfrm Ihal l aR+ Ihe owner ol the su~~ecl siie o~ am duiy aulnori=ed py Ihe own~r to aCl with respeCl to this, appliCalion. Further, I gran~ permissien Irom the owner to any ana all emplOyeeS anQ rep-eSenlaliveS Of Ih@ Cily ol Yelrry and olher gavernmenlal a9e~Cies to enler upon and inspeCt sa~d property as reasona0~y neces:.ary ~o process this applicai-on_ i agree lo pay all fees ol the ciiy Inai appiy to lhis applir,~tion_ S~gned Qaie `~a~ /~~ U JOS Y~J.~ A~•rn~~~ N~~l PO Bor 17! Yefin, NA 98591 (J601 ISA-JA]1 /~60~ ise.~l~1 FwX a•u•u•.ri_vrln~.ra.ur