20050011 Permit - Plat Amendment 07162013 0-:iH City of Yelm Permit No.: 20050011
Community Development Department Issue Date: 311512006
(Work must be completed within 180 days)
Building Division
Phone: (360)458-8407
VELM
Fax: (360)458-3144
Applicant:
Name: BOB BENUM Phone: 253-845-5555
Address: P.O. BOX 73130
PUYALLUP WA 98373
Property Information:
Site Address: 9211 WILKENSON ROAD SE Owner: APPLICANT
Assessor Parcel No.: 22718440600 Subdivision: MOUNTAIN SHADOW Lot:
Contractor Information:
Name: BOB BENUM Phone:
Address: BOB BENUM
P.O. BOX 73130
PUYALLUP WA 98373
Contractor License No.: Expires: 0/00/0000
Project Information:
Project: MOUNTAIN SHADOW PRELIMINARY&
Description of Work: Subdivide 19.93 acres into 80 single family lots. 9211 &9045 Wilkens
July 16, 2013 Application submitted for Plat Amendment.
Sq. Ft. per floor: First Heat Type (Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item Contractor Fees
PLAT AMENDMENT BOB BENUM (7/16/2013) $ 350.00
SUBDIVISION BOB BENUM $3,400.00
TOTAL FEES: $ 3,750.00
Applicant's Affidavit: OFFICIAL USE ONLY
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 #Sets of Prints:
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 Final Inspection:
registered in the State of Washington.
Date:
Signature Date
Firm By.