20090164 Permit Pkg 090309City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Applicant:
Name: CASA MIA
Address: PO BOX 1200
YELM WA 98597
Property Information:
Site Address: 1~d PRAIRIE PARK
Assessor Parcel No.:
Contractor Information:
Name: CASA MIA
Address:
PO BOX 1200
YELM WA 98597
Contractor License No.:
Permit No.: 20090164
Issue Date: 9/03/2009
(Work must be started within 180 days)
Phone: 400-2277
Owner: CASA MIA
Phone:
Expires: 0/00/0000
Lot:
Project Information:
Project: OTHER SPECIAL EVENT
Description of Work: ANNIVERSARY BANNER SEPTEMBER 3 - 17, 2009
Sq. Ft. per floor: First Heat Type (Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item Contractor Fees
SE CASA MIA $ 0.00
TOTAL FEES: $ 0.00
Applicant's Affidavit:
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
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 further certify that I am currently
registered in the State of Washington.
Signature Date
Firm
Subdivision:
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
ay:
Sep 03 09 11:078
1
Terry Cole
400-3133
p.l
~~ ~~
CommtinityDeueloprnertt Department
SPECIAL EVENT APPLICA7'tO.v
NAME OF PROJECT ~~}~1~,~~ p;,~ ~,q,~n~o ~/
~ ~. , ._
APPLICANT `~
Mailing Address ~ ~- 1 -
City, State and Zip _ ;'
Tetephone_~l~r ~ ~--It~~, -a.~ ~1 EMAIL
O WIPER
Mailing Address
City, State and Zip
Telephone EMAIL
SUMMARY OF REQUES T
sr~aRr DArF --
END DATE
PROPERTY DESCRlPTIDN
General Location 1?,u ~~ ~ ~ G(
Site Address
Assessor's Tax Parcel Number
a`t~rm that all answers 5latemens and m(ormation a5ove and submitted with this app6cat~on are c~Tafete and
accurate to the Dest of my knowledge I also 2:1irm that I am the oN•ner of the SuDtECt site Dr am t7u~y authCrxeC t: y
ShE Owner 10 act with respect l0 this a~plicai~Cn Furt'~er, t Brant t'erm~55~On frpm :hE Cwner to any enC 811
employees and ~epresentaUvES of the Ctty of YEIm Snd otnEr oovernmertal agenuES t~ Erter uaon any ms;e~
said property a: reasonably necessary to pfocess this apGiicat~on I agree to Fly all fees of the city that 2;~~y to
this 2pphcat~bn
Signed ~ ._..._ ~ ~ l f~ i L_4' ~:'V ~.x Date ~~ ~ ., V
PO Bor 1:9
}'elm, N:; 98597
(360) Jab-3b~3 .. ~ ~" ~"
(360) 15d-31 JJ F-ll' _~ !
u-ur-u•.Ci;.aJm.ua.ur ~JL.~
LIMITED TO 14 OAYSr 4 TIMES PER CALENDAR YEAR