20100170 Permit Pkg 09102010City 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: 134 PRAIRIE PARK
Assessor Parcel No.: 99002058849 Subdivision:
Contractor Information:
Name: CASA MIA
Address:
PO BOX 1200
YELM WA 98597
Contractor License No.:
Project Information:
Project: OTHER SPECIAL EVENT
Description of Work: ANNIVERSARY BANNER SEPT 3 THRU SEPT 17, 2010
Sq. Ft. per floor: First Heat Type (Electric, Gas, Other):
Second
Third
Garage
Basement
Lot:
Fees:
Item Contractor Fees
SE CASA MIA $ 0.00
TOTAL FEES: S 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.
Date
Firm
Permit No.: 201 ~~~ 70
Issue Date: 911 012 0 1 0
(Work must be completed within 180 days)
Phone: 400-2277
Owner:
Phone:
Expires: 0/00/0000
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
Sep 09 10 04:25p Terry Cole 40D-3133 p.l
Zc~12~dI 7~
City of Yel~n
Community Development Department
SPECIAL EVENT
LIMITED TO 14 DAYS, 4 TIMES PER CALENDAR YEAR
NAME OF PROJEC T ~-Y1t1 r .~. Sc, ~' ~ rt'~~~~ •~ y'
APPLICANT ~ `y
Mailing Address_,,,`~~i , ~~ t t Z c ~
City, State and Zip ~~-~ ~ ,,~.-~ , ~ ,'~'
Telephone >I.~r ~ ~--I~s,: -a.~ 1~l EMAI!
OWNER
Mailing Address
City, State and Zip
Telephone EMAIL
SUMMARYOF REQUEST
START DATE - ~ _. =='~
END DATE j
PROPERTY DESCRIPTION
General location l 2' ~ ~c~k,
Site Address
Assessor's Tax Parcel Number
I a'f~rm that all answers statements and iniprmat~on above anC submitte0 with this aapl~cauon are cvTp~e~e and
accurate 10 tttie OESt of my knOwledOe I also a~firT that I am t'1e o~n:ler o} the SUbJEC1 Site Dr am tlWy duthcrae~ ty
the owner to ac; with respell to thK aMpl~cat~:,n FuRr.er, I grant perm~ss~on frorr.:ne owner to any anC ail
employees and -epresentatrves of the City of Yelm and other aovernmErtal agenuES tc toter upon ahd rrue~
sa~tl property as reasonaoly necessary to Frockss this applicalian I a?ree t0 pey a!i ItEt:S of the city that zr~~y to
"h~a appncaaon
r
Signed ~ t i• ~~ ~ 4ji' Date ~ ` 1i9..J
JOS )-~l~n .4rrn~~ t1ial (36DJ 1S6-3b 33 ~ ~ "
YO Box !:9 (36D) J56-J11t F.l.C
)'tlm, 1t'.~ 9e597 p•~u~,ri;.rh,.na.w .' (~ J ~