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704 Yelm Ave W 'y�-r OF TNF A C I TY O F YE L M oFF��A��SE oN�Y � �, .p�� 105 Yeim Avenue W. �EE �3s o0 � � �� Yeim WA 98597 �<r,B,��E�_r�e�� - 4 M (360) 458-8437 OFFICE eid,a��FC�.._��//� (360) 458-4348 FAX t , Insp Dafe _ www.ci.yelm.wa.us --------- u� r��, YELM APPLICATION FOR WASHINGTON BUSINESS LICENSE {`�r ` � /�� Upon receipt of the license appiication and $35_00 paymen(, the Ci(y of Yelm wiif conducl an inspection of the premises for building and fire code conformance Upon approval from the Yeim Building Department of said premises, the Ci(y Clerk's Office will process the ap��lir:afion and mail license fo applicant al address listed below Application is hereby made for a Business License for the City of Yelm � NEW BUSINESS. C� NAME CHANGE/MAILING AD DATE %Z 3� ZQ� 3 DRESS CNANGE ONLY BUSINESS NAME T/yE S/�v�� / NATURE OF BUSINESS .•��Sj�(J��t��-- � .�� BUSINESS LOCATION ADDRESS �U � YE�/�-I ff jj� � MAILING ADDRESS %� O, �px �t�� i�� f�� ANTICIPA7ED OPENING DATE 3 f � `� � f� DAYS & HOURS OF OPERATION � •— �Z �1�^. OWNER(S) �� Birthdate �—Z Q._ ��t�,L y Address �.3�,�� /�'/�- CU%—�J�' /Z .r.✓�' 4� ��- � TELEPHONE J`�� O C�ty State 00 - 2.S�o� .�.�o .�59-�°7�Z z�p (Business) (Home/Emergency) CONTRACTOR'S REGISTRATION NO. TFiiJRSTON CO. HEALTH APPROVAL NO.a�plicabie) STATE OF WASHINGTON MASTER BUSINESS LICENSE NO. (UBI) G4,3 --��' � `'7�� Signature _��it,y��,��.G.Lf —i �' --__ __ Date � � CITY OF YELM BUSRJESS UCENSE APPI_ICATION Efi 5/08 I Page 1 of 1 ��shui��n �t�te I��ep�i�tment vf P��nu+e ��ate �usin�s�Re�c�►i�ds II�►��a��s� I)et�il TAX REGISTRATION fM0: 603363764 ACCOUNT OPEfVED: Q3�Q1 j201�4 12:OO:OQ AM UBI: 6Q3�63�6�# ACCOUNT CLOSED: OPEN EMTITY NAME: THE SILYER MIC LLC BUSINESS NAh1E: MAILING AQDRE55: BUSINE55 LOCATION: RQ B07C 994 F04 W YELM AYE RAINIER�t4'A 98576-0994 YELM,WA 98597`-767G ENTITY TYPE: LIMITED LIABILFTY RESELLER PERMIT NO: R30 328�I6 PERMIT EFFECTIYE: 03jI3f2014 NAICS CODE: 72�'S!1 PERMIT ESiPIRES: U3/'12/2Q16 MAICS QEFINITIUM: FULL-SERYICE RESTAUR�#NTS FC�R NDN-�(�k1MER�lAL U�EC�NLY Q3J17/2014 10:04 AM I http://dor.wa.gov/images/BRDImage.aspx?tra=Q/yccEDEyE1KMxECfGUOG7PKLXAO... 03/17/2014 / �f TN�A ' �4w �-�� City o f Yelm 4 � M Public Works Depdrtrr�ent 105 Yelrn Avenue West Yelnz, WA 98597 YELM wqsr��NCron ' Date: �'� 7-� . , , Property Address: � � � Business License Applicant: ��'' �-.. � �� 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 Assembly is required: C7 Prior to approval of your business license �ithin 3� days of change of ownership -- ❑ Not Applicable �t J�P°� � '�r<<s��-- hrr}-�k`�� Eqss�,.�lf� - Contact Kevin Ray, City of Yelm Public Works (360J 458-84'10 kevinrcr ci.yelm wa us for details on device opfions and inspection 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 from entering the system. Section 13.08.090 Yelm Municipal Code requires an appropriately sized grease interceptor to be installed prior to the STEP tank. Installation of a Grease Interceptor is required: -- --- ❑-P_rior#o approval of your business license - - - - -- --- - --- ----- _- - - -____--___----__- ithin days of change of ownership ❑ Not Applicable Confact Jim Doty, City of Yelm Public Works (360J 458-8411 'imd ci, elm.wa.us for details. �� CITY OF YELM FEE $75.00 �O� T�p�C, `4�v 'Py� INSPECTION a � BY DATE COUNCIL APPROVAL YLLM Motion # WASHINGTON DATE CABARET LICENSE License # �(�� APPLICATION (YMC Chapter 5.12) Business Name T'/�'L 5'`�, j��j� �r � Business Address_ 70 � �!�L/y �� (phone) 3�� aC�Z.S'� c� �� `�8'S'�� Ci� � State Zipcode Mailing Address �(�; �a X � ��L � �,g j��G� �� 9 �� Applicant's Name C�Ls�}�l� �, �� Last First Middle initial Applicant's Address f 3 7;,�y� �AlL Gla T-or� /2�/S�;�Phone) ,��f� .�S�— �6'�� Z Applicant's Date of Birth_ �}�2-0�/�� Applicants Business is a (please check one) individual partnership�corporation If a partnership, please list the names of all persons having an interest in the business: If a corporation, please list the names of officers and each stockholder owning directly or indirectly more than ten percent of the corporation's stock together with a statement of the total number of shares outstanding and the number of shares held by each of said stockholders. Corporation Officers % held Stockholders % held /7�i��.ti �S'�ql� GGj�1.�-/L ��Jc'J `�"� /?e��/t r- �l�0 t�Z�D�� /[7r�� Total number of shares outstanding �� MYDOC/FORMS/CABARET LICENSE 2002 � • s Please state the proposed location of the cabaret. f'�>�fl�.c�-y� �"�ttir¢C`�n.�`S� �'1`r�P�E c'�os�� , IZ�=o��i �s �--�� s��v�,c �-t�c 3 �' I�, �t Give a brief statement of the proposed plan of operation of the cabaret. i`°I�SiG �P,y 7`0 ��.vs� (��M �� oSi �V1G-�TS /9 T � /'?�y. AttaCYl an illustration of the proposed floor layout plan. Have you or any co-partner or stockholder been convicted of a felony within the last five years? /�p AGREEMENT BETWEEN APPLICANT.A1VD CIZ*y (yMC 5.12.090) I, ��+ a'�-V C��EK do undertake and agree to pay the expenses of the City incident to obtaining a special deputy marshal of the City who shall be on duty at the place of business of the applicant at any time the Mayor of the City determines that the maintaining of peace and order shall require the sexvices of such special deputy, and said agreement shall provide that said special deputy marshal shall be selected and appointed by the Mayor of the City. �i' ` ��'�'� � ��-�- 3 � Applicant' s Signature � � � Date MYDOC/FORMS/CABARET LICENSE 2002 . � STATE OF WASHINGTON County of Thurston _ �flb�-2T QLb��7 , being first duly sworn on oath deposes and says: , I am the above named applicant or duly authorized representative of the applicant, and make this affidavit for the purpose of obtaining from the City of Yelm a license to operate a cabaret as provided by the ordinance applicable thereto, and that I have personal knowledge of the matters stated in the forgoing application and the statements therein contained are true. SUBSCRIBED AND sworn to before me this 1� da of AR.C�i Y �--, ZOl� r DANIEL W. CR�WE STATE OF WASHINGTON NOTARY PUBIIC MY CpMMISSION EXPIRES � �7�19-16 NOTARY PUgLIC in and for the State of Washington, residing in G(.,� �,�A My Commiss on expires .� r��_ '� I Mydoc/notary cabaret/forms — i