20100129 INVOICECity of Yelm
Community Development Department
INVOICE
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Applicant:
Name: AMERICA'S CREDIT UNION
Address: 4545 S UNION AVE, STE 200
FORT LEWIS WA 98433-0338
Property Information:
site Address: 415 YELM AVE E
Assessor Parcel No.: 22719342800
Contractor Information:
Name: AMERICA'S CREDIT UNION
Address:
4545 S UNION AVE, STE 200
FORT LEWIS WA 98433-0338
Contractor License No.:
Permit No.
Issue Date
Phone:
20100129
05/16/2011
253-475-0380
Owner: TYPE CURRENT OWNER
NAME
Subdivision: Lot:
Phone:
Expires: 0/00/0000
Project Information:
Project: LAND SITE PLAN REVIEW
Description of Work: JUNE 27 TO JULY 24, 2010 TRAFFIC STUDY $1,793.75, JULY 25 TO AUGUST 21, 2010
TRAFFIC STUDY $751.75, NOV 21 TO DEC 25, 2010 CIVIL REV $1,020.88, FEB 20 TO MAR
26, 2011 CIVIL REV $2,717.31
Fees:
Item Contractor Fees
CIVL CIV AMERICA'S CREDIT UNION $ 6,283.69
SITE AMERICA'S CREDIT UNION $ 1,219.00
PAYMNTS MADE: $ 1,119.00
BALANCE DUE: $ 6,383.69
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.
Signature Date
Firm
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By: