20040155 Permit Pkg 093004I ~
City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax:(360)458-3144
Applicant:
Name: Color Me Mine
Address: City:
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Site Address: 133 Prairie Park
Assessor Parcel No. 64303700302
Contractor Information:
Name:
Address:
Contractor License No:
Subdivision:
Contact: Phone:
City: State: Zip:
Expires: Business License:
Lot:
Project: Color Me Mine Grand Opening
Description of Work: October 11-24, 04 Grand Opening via Sandwich Board sign
Sq. Ft. perfloor: (1st) 0 (2nd) 0 (3rd) 0 Garage 0 Basement 0
Heat Type (Electric, Gas, Other):
Fees:
Item Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc
--------------------------- ----------- ----------- -----------
Building Permit - Other 0.00 0.00 0.00 0.0000 0.0000 $1,000
TOTAL FEES: $0.00
ApplicanYs Affadavit:
OFFICIAL USI
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 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 St of Washington. Final Inspection:
Signature Date 9~ 0 Date:
By:
Firm
Permit No: SE-04-0155-YL
Issue Date: 09/30/2004
(Work must be started within 180 days)
Receipt No:
Phone:
State: Zip
'0~,~~ TH~pR~ City of Yelm
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Community Development Department
SPECIAL EVENT A.PPLICATION
OFFICIAL USE ONLY
Y E L M F~ NONE
WASMINGTON DateReccvetl~ r' ~/G9
By
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NAME OF PROJECT ~~~3N~ c~ ,of•v~ ~vc~
APPLICANT L-02 ~ ~~ ~v ~
Mailing Address 6 q~ L~~ S~'_
City, State and Zip ..e.. ~ 9 S' 9
Telephone~~D- ~ o-~sis/~ EMAIL ~le2~d'~o ~ 6, yc..~r..t/~.c~,y
OWNER G4 T/~i /e2
Mailing Address ~~
City, State and Zip
Telephone EMAIL
SUMMARY OF REQUEST % ~,~pos e, G~ a,~ ,~ ~',e,~ e~
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PROPERTY DESCR/P ION
General Location /~ ~ ~~~-e~ ~ //G-~
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Site Address Land Area (acres) ~
Section Township Range
Assessor's Tax Parcel Number
Full legal description of subject property (attach separate sheet if necessary)
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 as reasonably necessary to process this application. I agree to pay all fees of the city that apply to
this application.
/
Signed Date ~ 3U ~ ~~
]05 Yelm Auenue West
PO Box 479
Yelm, WA 98597
(360) 458-3835
(360) 958-3194 FAX
wu~u~.ci.yelm.u~a.ue