500 First Street ' ��
�,�- CITY OF YELM OFFICIALUSE NLY
/ �4� TNFp,�� 105 Yelm Ave. W. FEE $35.00
n Rec By
,,1+ 9r Yelm, WA 98597 Comm Dev.Dept.
a � (360) 458-8437 OFFICE Bidg Dept. � y ►'�
(360) 458-4348 FAX Insp.Date
www.ci.yelm.wa.us
Lic.No.
YELM APPLIGATION FOR
WASHINGTON BUSINESS LICENSE
Upon receipt of the license application and $35.00 payment, the 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 process the application and mail license to applicant at
address �isted below.
Application is hereby made for a Business License for the City of Yelm
� NEW BUSINESS ❑ NAME CHANGE/MAILING ADDRESS CHANGE ONLY
DATE _ I�T��1�C f-I % , �G� (�
BUSINESS NAME�_r C.k.� y��L'�( {�(J'(� !'�'
NATURE OF BUSINESS � .�L !._ �
BUSINESS LOCATION ADDRESS � C� ��� �( �/"G G� ��016� � t`'`/�
tc�'f 1i��
MAILING ADDRESS_ f � � CS� CJ � 1 �,C'`G''�
ANTICIPATED OPENING DATE_��I YI�C tt �, �O f y
DAYS 8 HOURS OF OPERATION����5� !I'OC��� ���, -{' ��-l"�- �,j��,� �(
OWNER{S) ����11 ��LN -=�-�-S�I ��FS�Vjt,�S1. �/F ���
Birthdate��—� ',��
Address���! r��if� � �f %/G ,,�/� S� v�"�/t't ZJ� /d�� (
City � State Zip
TELEPHONE�Cs� G - ? qG -� � �/�� S�� �_
(Business) (Home/Emergency)
CONTRACTOR'S REGISTRATION NO.
(If applicable)
THURSTON CO. HEALTH APPROVAL NO.
STATE OF WASHINGTON MASTER BUSINESS LICENSE NO. (UBI)�;�D32�v� /G�
Signatu[�'...�"�� �------ ate �',�A�'��� �G��
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Page 1 of 1
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TA}C REGISTRATION NO: 603212703 ACCQUNT QPENED: 06 f 01�2012 12:OQ:OQ AM
UBI: �03Z12703 ACCOUNT CLOSED: OPEN
ENTITY NAME: NEW YELM GROUP
BUSINE55 NAME:
MAILING ADDRE55: BUSINE55 LOCATION:
PO BOX 681 500 15T ST 5
YELM,M�A 98597-0681 �'ELM�WA 98597-7671
ENTITY TYPE: A�SOCIATION RESELLER PERMIT NO: N/14
PERMIT EFFECTIYE: N/A
MAICS CUDE: 813410 PERMIT EXPIRES: M/A
NAICS DEFINITIdN: CIYIC AMD SOCIAL
ORGANIZATIONS(PT}
F(�R N�N-��MMER�GI►AL U�E �NLY
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4�f TH�A 9� Ci ty o f Ye l m
ti �
4 �"'ef
Public Worhs DepartrrLent
105 Yelm Auenue West
Yelrn, WA ,98597
YELM
WAS�,��ro�
Date: � � �L
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Property Address: �j Cr" ��?��?�1�GG �G�GL6(�
. �9n �� �lc�'� �
Business License Appiicant: � ' �r S� ��� /�u��-
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 Assembl is required:
❑ Prior to approval of your business license
❑ Within day change of o r� ip �
Not Ap icable Y
L��.
Contact Kevin Ray, City of Yelm Public Works (360) 458-8410
kevinr(a�ci.yelm wa us for details on device options and inspecfion
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, oils and greases fram entering the system. Section 13.08.090 Yelm Municipal
Code requires an app�opriately sized grease interceptor to be installed prior to the
STEP tank.
Installation of a Grease Interceptor is required:
-- ------ -�__Prior to approval-of your business-license-- -
- - ---- - - ---
-__ ____- _ _ _--- ---_
�❑ Within days of change of ownership
Not Applicable
/
Contact Jim Doty, City of Yelm Public Works (360) 458-8411
Lmd(a�ci.Velm.wa,us for details.