20100034 Permit Pkg 021210City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360)458-3144
Permit Ivo.: 20100034
Issue Date: 2/12/2010
(Work must be started within 180 days)
Applicant:
Name: NISQUALLY INDIAN TRIBE Phone: 360-456-5221
Address: 4820 SHE NAH NUM DR
OLYMPIA WA 98573
Property Information:
Site Address: 1318 YELM AVE WEST Owner: NISQUALLY INDIAN TRIBE
Assessor Parcel No.: 21724210102 Subdivision:
Contractor Information:
Name: NISQUALLY INDIAN TRIBE Phone:
Address:
4820 SHE NAH NUM DR
OLYMPIA WA 98573
Contractor License No.: Expires: 0/00/0000
Project Information:
Project: DEMOLITION
Description of Work: DEMO CHARLES HOUSE ORCAA PERMIT #10 DEM0002549
Sq. Ft. per floor: First Heat Type (Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item
DEMOLITION
Contractor
NATIVE LAND DEVELOPMENT
Lot:
TOTAL FEES:
Applicant's Affidavit:
I certify that I have read and examined the information contained within the application and know the same
to be irue 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 to of Washington. n
Signature Date ~ ~ I f- ~ l~>
Fees
$ 50.00
5 50.00
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