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20090018 Permit Pkg 020209City of Yelm Community Development Department Building Division Phone: (360)458-8407 Fax: (360)458-3144 Applicant: Name: The Taxman Address: Property Information: Site Address: 106 Edwards Assessor Parcel No. 85800300700 Contractor Information: Name: Address: Contractor License No: Project Information: Project: Pat Fetterly Description of Work: Special Event Sq. Ft. per floor: (1st) 0 Heat Type (Electric, Gas, Other): Fees: Item TOTAL FEES Applicant's Affadavt: (2nd) 0 City: Subdivision: Contact: City: Expires: (3rd) 0 Permit No: SE-09-0018-YL Issue Date: 02/02/2009 (Work must be started within 180 days) Receipt No: Garage 0 Item Fee Base Amt Unit Fee Unit Rate $0.00 Phone: State: Zip Phone: State: Zip: Business License: Basement 0 Lot: No. Units Unit Desc 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, i easements and restrictions of record. If applying as a ontractor, I futher certify that I am currently registered in the S f Washington. Signature ~ Date ~ ~ "- G~ ~ _ j -__ _ -___ _ ._- - _ - I _- - Firm # Sets of Prints: Final Inspection: Date: By: City of Yelm V~ ~ YELM WASHINGTON Community Development Department SPECIAL EVENT / TEMPORAR Y USE APPLICATION 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 ~~ ~ -~ ~,. (, Mailing Address ~ , , City, State and Zip y.~' ~~ 2~ « 9 S~lj Telephone~uo y5~ .'~~i ~ EMAIL ~u tfPtferl/ ~ r~y~ictc~S~~~ ~~ City of Yelm Business License Number SITE OWNER ~ ~Y Mailing Address City, State and Zip ~, ~ 9 S ~~ Telephone ~~ ~ - EMAIL ~ -F>< .~ _ ~~ ~- ~~ SITE ADDRESS/LOCATION D - c! S ~ ~ ~ .~ , SITE PARCEL NUMBER SUMMARY OF REQUEST n •~ G START DATE ~ Z ~ END DATE ~,/il~~,/,L ~~~ S~- 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 re sonably necessary proces this a plica ion. s~ Sign Date ~~~~'~ V ROUTING: SPECIAL EVENT Building Section TEMPORARY USE Planning Section Building Section ]OS Yelm Auenue West (360) 958-3835 PO Box 479 (360) 458-3144 FAX Yelm, WA 98597 www.ci.yelm.wa.us