20090119 Permti Pkg 062409v
City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360)458-3144
Applicant:
Name: Road Runner
Address: 203 Yelm Ave. West City: Yelm
Property Information:
Site Address: 203 Yelm Ave. NE
Assessor Parcel No. 99002045417 Subdivision
Name: Contact:
Address: City:
Contractor License No: Expires:
Project Information:
Project: Road Runner
Description of Work: Special Event 6-25-09 to 7-9-09
Sq. Ft. per floor: (1st) 0 (2nd) 0 (3rd) 0
Heat Type (Electric, Gas, Other):
Permit No: SE-09-0119-YL
Issue Date: 06/24/2009
(Work must be started within 180 days)
Receipt No:
Phone: 458-9665
State: WA Zip 98597
Lot:
Phone:
State: Zip:
Business License:
Garage 0 Basement 0
Fees:
Item Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc
TOTAL FEES: $0.00
Applicant's Affadavit:
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 futher certify that I am currently
registered in the State of Washington.
Signature - ! \ Date ~ 01 O
Firm
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
City of Yelm
~' ~ Community Development Department
SPECIAL EVENT /TEMPORARY USE
Y E L M APPLICATION
WASHINGTON
~, Special Event Sign Permit (limited to 14 days, 4 times per calendar year)
Temporary Use (property owner permission letter required)
(see REVERSE for regulations)
NAME OF PROJECT
APPLICANT/BUSINESS NAME ~ S S
Mailing Address ~ ~ ~
City, State and Zip ~ 'Ps-
Telephone ~ b~ -- ~ S R-ci b ~~~ EMAIL
City of Yelm Business License Number
SITE OWNER
Mailing Address
City, State and Zip
Telephone EMAIL
SITE ADDRESS/LOCATION ~- ~ ,~ 1
SITE PARCEL NUMBER
SUMMARY OF REQUEST ~ ~ ~
~~ ~
START DATE (o - o END DATE --
Iaffirm 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.
Signed r ~ Date ~ ~~~ ~I
ROUTING: SPECIAL EVENT Building Section
TEMPORARY USE Planning Section Building Section
105 Yelm Avenue West (360) 458-3835
PO Box 479 (360) 458-3144 FAX
Yelm, WA 98597 www.ci.yelm.wa.us