20130314 Permit Pkg 09042013 �OF�N�A� City of Yelm Permit No.: 20130314
� � Community Development Department Issue Date: 9/04/2013
(Work must be completed within 180 days)
Building Division
Phone: (360)458-8407
`"""'"`_°" Fax: (360)458-3144
Applicant:
Name: CASA MIA Phone: 400-2277
Address: PO BOX 1200
YELM WA 98597
Property Information:
Site Address: 134 PRAIRIE PARK ST SE owner:
Assessor Parcel No.: 99002058849 Subdivision: Lot:
Contractor Information:
Name: CASA MIA Phone:
Address:
PO BOX 1200
YELM WA 98597
Contractor License No.: Expires: 0/00/0000
Project Information:
Project: OTHER SPECIAL EVENT
Description of Work: ANNIVERSARY BANNER, SEPT 3 THRU 30, 2013
Sq. Ft. per floor: First Heat Type(Electric,Gas, Other):
Second
Third
Garage
Basement
Fees:
Item Contractor Fees
SE CASA MIA $ 0.00
TOTAL FEES: S 0.00
ApplicanYs/�ffidavit: OFFICIAL USE ONLY
I certify that have read and examined the information contained within the application and know the same
to be true a d c rect. I also certify that the proposed structure is in conformity with all applicable City of #Sets of Prints:
Yelm regul tion fi ing ose governing zoning and land subdivision,and in addition,all covenants,
easements an r riction of record. If a plying as a contractor,I further certify that I am currently Final Inspection:
registered i th ate o ashington.
Signature w- Date "/ Date:
Firm BY'
pC,a�V�/ %
aw�� T�A��` City of Yelm
� �
Community Deuelopment Department
SPECIAL EVENT/TEMPORA.R Y USE
APPLICATION
YELM
WASMINGTON
Special Event Sign Permit (�imitea to �4 days, 4 times per calendar year)
TetllpOrar'y USe (property owner permission letter required)
(see REVERSE for regulations)
NAME OF PROJECT nY�t��� )e�Cc:�I .l > �n�vr
, ,
APPLICANT/BUS/NESS NAME
Mailing Ad ress 1�—I c�ru„ ,,= '���- Y_ C_�ra-�-,-P
�T �
City, State and Zip
Telephone �"�i.p�-�1� � a��� EMAIL
City of Yelm Business License Number
SITE OWNER� �- -�' - - I -f-- S-f���c �
Mailing Address �- C�� �� �a-r��
City, State and Zip �--t�j rY-� �,,:� ,-4
Telephone ?,�o-�� �- �c� � EMAIL
S/TE ADDRESS/LOCAT/ON
SI TE PARCEL NUMBER
SUMMARY OF REQUEST
START DATE END DATE J
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 as reasonably necessary to process this application.
Signed �� 1 G ..�t �.�� Date //�1 � ( 3
1 �
ROUTING: SPECIAL EVENT Building Section
TEMPORARY USE Planning Section Building Section
105 Yelm Avenue West (360)458-3835
Yelm, WA 98597 (360) 458-3144 FAX
www.ci.yelm.wa.us