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20090096 Permit Pkg 060509City of Yelm Community Development Department Building Division Phone: (360) 458-8407 Fax: (360)458-3144 Applicant: Name: Clarks Bar And Grill Address: 15425 Mosman Property Information: Site Address: 15425 Mosman Ave SW Assessor Parcel No. Contractor Information: Name: Address: Contractor License No: Project Information: Project: Clarks Bar and Grill Description of Work: Clarks 1st Anual Hot Rod Show Sq. Ft. per floor: (1st) 0 (2nd) 0 Heat Type (Electric, Gas, Other): City: Yelm Subdivision: Contact: City: Expires: (3rd) 0 Permit No: TEMP-09-0096-YL Issue Date: 06/05/2009 (Work must be started within 180 days) Receipt No: Phone: 4583332 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 5(ANNED w2Prsi IC 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 ` - ~ - ~ Firm OFFICIAL USE ONLY Sets of Prints: final Inspection: Date: ' ~,~~ T~Ep~~ City of Yelm Community Development Department SPECIAL EVENT /TEMPORARY USE Y E LM 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 ~. L~~S ~'-''~~~~~L ~ ~~,,,~~ ~~ APPLICANT/BUSINESS NAME ~ `5t 12- ~ L Mailg Address_1S~ZS" (~OSr11ilA~-J ~y ~ ~y~/ City, State and Zip [~ 5 Telephone ~,v ~ EMAIL L r ~ q,r ~w~/,ca~ City of Yelm Business License Number,~g - ~9D0%~I'8- C\~i~~ SITE OWNER a~ ~ Q ~~,~-~- o~ F, G ~ ~ t_L Mailing Address ~P.©. ~Hc (,~~ City, State and Zip_'(L~.t.vl -e~ vJ~., ~gc~- -.~ Telephone 3~c~ '-~~ 01~-u EMAIL R~~, iv~c ~ r3a.uG ~~ SITE ADDRESS/LOCATION 1~~ Z ~ 1f~1iOSY~tGt-ice ~,~ ~ Y ~~ vJ44 °l~ 5~ ~- S/TE PARCEL NUMBER. ~l-1 ~-~~-W-(7 `~® SUMMARY OF REQUEST '(l7 rdlybJ[,~ ~ L'~~R.- ~~ IN `~ PPrCZk-[ 1~1i, ~ rt~i~. ~~,,, ~',ovF l'rs~.P...S~ , START DATE S~ ~~ l ~ , '1 ~~~ END DATE Sr; - ~ 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 reas/onably necessary to process this application. Signed~~`_ ~ (~lrl's c.:t~~'~ . ~P Dates (IO~j ROUTING: SPECIAL EVENT Building Section TEMPORARY USE Planning Section Building Section 105 Yelm Avenue West PO Box 479 Yelm, WA 98597 (360) 458-3835 (360) 458-3144 FAX www.ci.yelm.wa.us MAY 2 2 2009 r.r/ ~ 3 ~~ ~ ~~ J J ~~.L J /~ 1-~- \~ I r E( 2 2 Q 3 s 0 0 ,~ a :J .J V \~ t~