20130249 Permit Pkg 06252013 o� � City of Yelm Permit ►vo.: 20130249
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: YELM CO-OP Phone: 360-400-2210
Address: PO BOX 75301
YELM WA 98597
Property Information:
site Address: 308 YELM AVE E owner:
Assessor Parcel No.: 99000114600 Subdivision: Lot:
Contractor Information:
Name: YELM CO-OP Phone:
Address: BETSY PEABODY
PO BOX 75301
YELM WA 98597
Contractor License No.: Expires: 0/00/0000
Project Information:
Project: OTHER SPECfAL EVENT
Description of Work: BRATS AND BEERS FUNDRAISER,JUNE 27,2013
Sq. Ft. per floor: First Heat Type(Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item Contractor Fees
SE YELM CO-OP $ 0.00
TOTAL FEES: $ 0.00
Applic Ys Affidavit: OFFICIAL USE ONLY
I certify hat I have read and examined the information contained within the application and know the same
to be tr e and correct. I also certify that the proposed structure is in conformity with all applicable City of #Sets of Prints:
Yelm r ulations i ding those governing zoning and land subdivision, and in addition,all covenants,
easem ts a d stri tions of record. If applying as a contractor, I further certify that f am currently Final Inspection:
register d in e Sta of Washi gton.
Signatur �t7 Date Date:
Firm gy�
�FT�p Cit o Yelm ���2`�G
4�. y f
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°' Community Deuelopment Department
SPECIAL EVENT/TEMPORAR Y USE
APPLICATION
YELM
wwsN�wcroe�
Special Event Sign Permit (�imited to �4 days,4 times per calendar year)
TerllpOrary USe (property owner permission letter required)
(see REVERSE for regulations)
NAME OF PROJECT �P� ,4�� �/�-��S ����✓�
APPL/CANT/BUSI SS NAME ,- ,�
Mailing Address � �r a ' � Z.-
City, State and Zip �
Telephone oo ,ZZ�a EMAIL �- � G �r'
City of Yelm Business License Number /��-- o -337� ° /
SITE OWNER 'L %�� e
Mailing Address 30� _�c,�,-_ ,¢�-� �
City, State an Zip C�/,� lS�`,i
Telephone �6a``7'S�- 7.�,5� EMAIL /�C�. (�q�,-��q,� c� ,
SITEADDRESS/LOCAT/ON ���'(�S!F_j�! /�rJE F_
SITE PARCEL NUMBER D O al>
SUMMAR�F REQ��T �c �'
�f1/
START DATE �/�,.�,,• z 7 END DATE ��,,..e z 7'
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 prope reasonably necessary to process this application.
Signed Date /�i$ / Z� � �cE�v D
3
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ROUTING: SPECIAL EVENT Building Section
TEMPORARY USE Planning Section Building Section
105 Yelm Auenue West (360)458-3835
PO Box 479 (360)458-3144 FAX
Yelm, WA 98597 www.ci.yelm.wa.us
Thurston County Public Heaith and Social Services
�� Environmental Health Division
'�"� 412 Liily Road NE Olympia, WA 98506
�
- ,�.:�� �" Phone (360) 867-2667 Fax (360) 867-2600
__:�___�—.___:__
THURSTON COUNTY TDD (360) 786-5602
st�vice iss
Temporary Food Service Establishment Operating Permit
Permit: 13108121
Dates of Operation: 06/27/2013 - 06/27/2013
Event: Beer& Brat Fest
Location: Ye{m Co-op
Yelm Food Co-Op
Merilyn Reardon
PO BOX 3061
YELM 98597
Menu: Brats, Hot Dogs, Sauerfcraut, Chips, Ice Cream Bars, Beverages, and Condiments
*Addition or change of inenu andlor equipment requires review and approval by this department
prior to the event
The above referenced organization is authorized to operate at the above location as a temporary
food service. This authorization is contingent upon compliance with applicable laws, inciuding but
not limited to WAC 246-215, Article 11 Thurston County Sanitary Code and other conditions set forth
by the Health Officer. Failure to comply may result in Permit suspension or revocation or the
imposition of other sanctions as provided by law.
�
Thuston County Health Officer or Designee
I, the undersigned, understand the conditions of the Permit and do agree to follow said conditions
understandinq that refusal do so will result in the suspension or revocation of the permit.
�l.�c_.�,��� � ---�.�i-���,
Signature of erator
See reverse side for Permit conditions and checklist
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me. _ �
Temporary Food Service Operating Conditions: �;�
'! Your temporary food service application has been reviewed by this office and accepted with the following
corrections, add�tions, or changes. �
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`� ❑Eliminate bare hand contact with effective use of utensils and/or wearing disposable gloves. x�
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; ❑At all times there shall be at least one person with a valid Food Worker Card present. �
a �.
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� ❑Bring several thermometers for checking/monitoring food temperatures. Bring a digital thermometer when ,;
� checking thin cooked foods(i.e. hamburgers). Keep a thermome ter insi de each ice chest to monitor k�
>�.,
± temperatures for cold holding.
;1 ❑Wash, rinse, and sanitize equipment or utensils every 4 hours if the same utensils will be continuously used �,
{ throughout the day. Bring extra utensils as backup. �
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�
� ❑You need to have a hand wash station in the outside food prep area-5 gallon insulated container with �-:.
'� warm (105°F)water dispensed via a continuous flow spigot, a waste water catch bucket, soap, paper
y towels&trash receptacle for paper towels(and other trash). Recommended for the beer garden too.
`� ,'
� ❑Set up, use&maintain at proper disinfectant residual levels(e.i. chlorine befinreen 50-200 ppm)a counter �-�
�� wipes solution-check occasionally during the event with test strips. Recommended for the beer garden �n
too. �
� ❑Remember to providelhave available on-site a food probe thermometer that is accurate 2° increments. �
�,'� �::
,
; �If providing condiments other than mustard, ketchup, please call (867-2574)to discuss proper �:
� dispensing/storage needs. �`
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� HOME PREPARED FOODS ARE NOT PERMITTED `
Beer and Brats for the Yelm Cooperative
This event will be held from 4 to 9 PM on Thursday, June 27 before and during the
Prairie Days parade. The parking lot will be officially blocked by the parade during our
business hours. This will prohibit vehicle traffic into the parking lot. Because of this
impact to our businesses (Yelm Food Co-op and Gordon's Garden Center) during this
time period, we are asking that we be allowed to use up to 12 of our 24 parking places
for this event. Normal business hours for both businesses end at the parade start time
of 7:OOpm. However, both businesses will likely extend our hours to accommodate foot
business during this time.
For the beer garden portion of the event, the Liquor Control Board requires a secured
area defined with barriers. We will have seating and tables in this area.
For the food service portion of the area, we will also provide limited seating but most
people will be free to leave the area with their food.
Other activities sueh as face painting are planned for children.
The beer and food service areas will be under tents. Seating will be open.
;
�.��C���T�D
= MAY l4 2013
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Washington State Liquor Control Board
Olympia, Washington
SPECIAL OCCASION LICENSE
Special Occasion Number: 3732 License Number: 407645
YELM COOPERATIVE
GO BEVERLY WRIGHT
308 EAST YELM AVENUE
YELM,WA 98597
is hereby licensed to sell beer, wine and spirituous liquor to be consumed only at the
location, date(s), and time(s) listed below.
YELM FOOD COOPERATIVE—308 EAST YELM AVENUE, YELM
JUNE 27,2013 4:00 PM TO 10:00 PM
in accordance with and subject to the provisions of the Washington State Liquor Control
Act and the rules and regulations of the Washington State Liquor Control Board.
Sales, service and consumption is confined only to the designated location(s)
Persons under the age of 21 years are expressly prohibited from entering the enclosed
area during the operation of the special occasion event.
The award, sale or gift of beer, wine or spirituous liquor for consumption outside the
designated location(s) is expressly prohibited.
If you have any questions, please contact April Cotton at (360) 664-1610, Samiel
Williams at (360) 664-1662 or your local liquor agent at(253)471-5200.
Dated in Olympia, Washington on Thursday, June 20, 2013.
SFiaron Foster
Chairman
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MAY 14 2013
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