20130251 Permit Pkg 06252013 o� City of Yelm Permit No.: 20130251
Community Development Department Issue Date: 6/25/2013
� (Work must be completed within 180 days)
Building Division
Phone: (360)458-8407
«"`» �°" Fax: (360)458-3144
Applicant:
Name: NISQUALLY BASIN YOUTH BASEBALL Phone: 360-239-6884
Address: PO BOX 1691
YELM WA 98597
Property Information:
Site Address: 105 SECOND ST SE owner:
Assessor Parcel No.: Subdivision: Lot:
Contractor Information:
Name: NISQUALLY BASIN YOUTH BASEBALL Phone:
Address:
PO BOX 1691
YELM WA 98597
Contractor License No.: Expires: 0/00/0000
Project Information:
Project: OTHER SPECIAL EVENT
Description of Work: QUILT RAFFLE, JUNE 27,2013
Sq. Ft. per floor: First Heat Type(Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item Contractor Fees
SE NISQUALLY BASIN YOUTH BASEBALL $ 0.00
TOTAL FEES: $ 0.00
Appli anYs Affidavit: OFFICIAL USE ONLY
I certi that I have read and examined the information contained within the application and know the same
to be rue and correct. I also certify that the proposed structure is in conformity with all applicable City of #Sets of Prints:
Yel regulations including those governing zoning and land subdivision,and in addition,all covenants,
ease en strictions of r cord. If applying as a contractor, I further certify that I am currently Final Inspection:
regis ere in the ate of W h gton.
Sign tur I � Date Date:
By:
Firm
2a��a5 f
4�,�� T�p City o f Yelm
_ �
Community Deuelopment Department
SPECIAL EVENT/TEMPORAR Y USE
APPLICATION
YELM
WAiMINGTON
Sp�cial Event Sign Permit(iimitea to �a aays,4 times per calendar year)
TempOrary Use (property owner permission letter required)
(see REVERSE for regulations)
NAME OF PROJECT 1 ��l �-�'�?E" �(��`� ��C -
APPLICANT/BUS/NESS NAME ° l� .� �i -
Mailing Address�.r,� ���k. j��t l ``
City, State and Zip ' � ` � `° �
Telephone '` _'�`� EMAIL �a� � ��'►1�r_i�`�< <�;�,.�.-�-. <<<=�,r
City of Yelm Business License Number
SITE OWNER " ` - � -� !�
Mailing Address -C� � F3�'x ���1 ��
City, State and Zip
Telephone '� '" -`1�1 " ��� EMAIL -�- �- � ,
SITE ADDRESS/LOCAT/ON �-
SITE PARCEL NUMBER
SUMMARY OF REQUEST ;� � � '� ` � '� r �"��?���` !�`'
���+���,^�� � � ' r � ��
. )
START DATE f,�,�� y � " � END DATE l,, 'a�-;�
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� s reasonably ecessa�i o process this application.
Signed � �- � ✓ � Date l„� ` ��:�.A' �°,? _
�
ROUTING: SPECIAL EVENT Building Section
TEMPORARY USE Planning Section Building Section
105 Yelm Aoenue West (360)458-3835
PO Box 479 (360)458-3144 FAX
Yelm, WA 98597 www.ci.yelm.wa.us