1109 Yelm Ave E C ITY O F YE LM OFFICIAL USE ONLY
�O� TH'E1��� 105 Yelm Ave. W. FEE $35.00
Rec By
�Q 9� Yelm, WA 98597 Comm Dev.Dept.
4 � (360) 458-8437 OFFICE Bldg Dept.
(360) 458-4348 FAX Insp.Date
www.ci.yelm.wa.us
Lic.No.
YELM APPLICATION FOR
WASHINCTON BUSINESS LICENSE f� � ��
�
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 listed below.
Application is hereby made for a Business License for the City of Yelm
� NEW BUSINESS � NAME CHANGE/MAILING ADDRESS CHANGE ONLY
DATE (Q/ ! I Z�� jA
BUSINESS NAME (o1�T N� S��N� �I Qfi��L�L�S
NATURE OF BUSINESS �C��� C ���0��_S ���
BUSINESS LOCATION ADDRESS l 1 v y �Y��M �. `i "C/I IM A/l�� ` �� , �
MAILING ADDRESS P` G�` �J�y` �Z� J'1 v 1`G��. (J z. �7C1I�
EMAILADDRESS rC1 V� �iLV) II� A, W'ttJ�'ey� FI VC�+L-�l/�• f L���
ANTICIPATED OPENING DATE J��'�%�- Z
�', Zt�14
DAYS 8� HOURS OF OPERATION ��2� � /�� (U �G�L'�� '' �I��`��1,�►z'�^
OWNER(S) ��L�JI�`��`-� �) �LG�'Lti��S
Address � � I,t�7� "l2 � !1 v���'�" � -�J �CSG'
/� �q �� City —7' State Zip
TELEPHONE ����� lt�� ?'1 � ��1�1'J 5 (/� "� ��l� `� S��Cr�
(Business) (Home/Emergency)
CONTRACTOR'S REGISTRATION NO. N y J�
(If applicable)
THURSTON CO. HEALTH APPROVAL NO.
STATE OF WASHINGTON MASTER BUSINESS LICENSE NO. (UBI) �!�� 4 3 7 J 3 S�
Signatur Date �l � �L'''1
�OfTHFA�� Cit o Yelm
4q 9r � �
4 �t..�i1
Public Worhs Depczrtment
105 Yelm Auen,�e West
Yelnt, WA 98597
YELM
wasr��r�crow
Date: �
� � V
Property Address: � �
Business License Appiicant: � " � C.�
Dear Applicant:
Section 13.04.220 YMC requires ali commercial buildings and irrigation systems to have
a Reduced Pressure Backfiow Assembly (RPBA) device installed on the water services.
Installation of a Reduced Pressure Backflow Assembiy is required:
❑ Prior to approval of your business license
❑ Within days of change of ownership
�5 Not Applicable ��
�i� I�
;
Confact Kevin Ray, City of Yelm Public� Works (360) 458-8410
kevinr(c�ci.velm.wa.us for details on device options and inspection
requirements.
Fats, oils, and greases entering the City of Yelm STEP sewer system can adve�sely
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:
__--___�_�-rior-t�-appr�ual-oT-your business licer�se - . __-.--- - --- - .- - _ _: _ ._._ _ __ _ . - -
❑ Within days of change of ownership ,
� Not Applicable � �J ��
Contact Jim Doty, City of Yelm Public Works (360) 458-8411
Lmd(c�ci.Velm.wa.us for details,