109 Yelm Ave East (2) C ITY O F YE L M OFFICIAL USE ONLY
� Of TNF�',p� 105 Yelm Avenue W. FEE g3s o0
�O� .� Rec BY---
♦ � Yelm WA 98597 co�»�n �e� r,��� _______
4 � �, (360) 458-8437 OFFICE �,��, ��,,, ________ _ --
��' (360) 458-4348 FAX
i�s�_o��e_ �
� www.ci.yelm.wa.us - --
E� uc No ---- -- �
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YELM APPLICATION FOR
WASHINGTON BUSINESS LICENSE
Upon receipt of the license application and $35 00 payrTient, tf�e City of Yelm will conduct an inspection of
the premises for building and fire code conformance Upon approval from the Yelm Building Department
of said premises, the City Clerk's Office will proress the application and mail license to applicant at
address listed below.
Application is hereby made for a Business License for the City of Yelm
L� NEW BUSINESS C� NAME CHANGE/MAILING ADDRESS CHANGE ONLY
DATE __� ,� \ �p�\
BUSINESS NAME ��,,��.^ /�)�,,�� n, /L�� Zry�'�,�� � ��-���
/__+-L...1_
NATURE OF BUSI S�F�_���`<<�--
BUSINESS LOCATION ADDRESS _ /�� S'et,,,,� �� `,,� �GS �— � f m ��� (��q►?
MAILING ADDRESS �n �(17 � (� �Prti�( �G�� ���tr.l S� y.t�r•r� ������ �
ANTICIPATED OPENING DATE _`�� � �;f�
DAYS & HOURS OF OPERATION �,�r�- �yy�_
OWNER(S) �m i R L;�Gn��f
Birthdate L�;(/� /���_
- � ��---T-
Address ,r]�'Q.� �IPr� '��-ri,° �����/�l�' �� ����9� (
City State � � Zip
TELEPHONE ___��('� - �S� ' �QtJ�
(Business) (Home/Emergency)
CONTRACTOR'S REGISTRATION NO.
(If applicable)
THURSTON CO. HEALTH APPROVAL NO.
STATE ( ��:Q �'� ,
OF WASHI GTON MASTER BUSINESS LICENSE NO (UBI)�D����j� � ��L
, � � �
Signature Date S 3
CITY OF YELM
BUSWESS LICENSE APPLICATION \\
EK SI08 �rlU�� �I
Page 1 of 1
��shulgtor� State D�p�i�nent of Revenue
St�te Bu�irtess Recorcis Datab�ase Detail
TAX REGISTRATION NO: 603096559 ACCOUfVT OPENED: 03/O1/2011
UBI: 603096559 ACCOUNT CLDSED: OPEN
ENTITY NAME: LIZOTTE AMIE L
BUSINESS NAME:
MAILING ADDRESS: BU5INE55 LOCATION:
17805 QEAR LAKE BLVD SE 204 YELM AVE E
YELM,WA 98597-8955 YELM,WA 98597-7649
ENTITY TYPE: SOLE PROPRIETOR RESELLER PERMIT NO: N�A
PERMITEFFECTIVE: NfA
NAICS CODE: 812112 PERMIT EXPIRES: N,fA
NAICS DEFINITION: BEAUTY SALONS
F�R N(�N-C�MMER�IAL USE C]NLY
O1 j28/2013 2:47 PM
http://dor.wa.gov/images/BRDImage.aspx?tra=aJhCYSR4v4yRsnzInDAfFufgu9UH7/6N... O 1/28/2013
��f THE A 9� Ci ty o f Ye l tn
`O r
a M
Public Worhs Dep�irtr�aertt
105 Yel�n Auerti�e 66'esC
Yelrri, Gi�A 9gSg7
YELM
wnsr�ir�cron
Date ` ������
Property Address: �� _ _� . � __ � C,(� �d ��
�
Business License Applicant � ] ��
Dear Applicant:
Section 13.04.220 YMC requires all commercial buildings and irrigation systems to have
a Reduced Pressure Backflow Assembly (RPBA) device installed on the water services.
Installation of a Reduced Pressure Backflow Assembly is required�
❑ Prior to approval of your business license �S�'�`��
❑ W�in days of change of ownership '����
��ot Applicable t,pP�i�
r
Confact Kevin Ray, Cify of Yelm Public Works (360) 458-8410
kevinr(a�ci.�elm.wa.us for details on device options and inspection
requirements.
Fats, oils, and greases entering the City of Yelm STEP sewer system can adversely
affect the operation of the plant and the City requires all appropriate measures to avoid
fats, oi!s and greases from entering the system. Section 13.08.090 Yeim Municipal
Code requires an appropriately sized grease interceptor to be installed prior to the
STEP tank.
Installation of a Grease Interceptor is required:
C Prior to approvai oT your pusiness license
❑ Within days of change of ownership
❑ Not Applicable
Contacf Jim Doty, City of Yelm Public Works (360J 458-8411
jimd a�ci.yelm.wa,us for details,