9144 Burnett Rd SE (2) CITY 4F YELM OFFlCIALUSEONLY
��0� T�I� 105 Yelm Ave W R���-0°
Q �� Yelm WA 98597 c�m��.� t.
� � (360) 458-8437 OFFICE �,�
(360) 458-4348 FAX ��p_Date
www.ci.velm.wa.us
Lic.No.
YELM APPLICATION FOR �
WASMINf'TON BUSINESS LICENSE � ����
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Upon receipt of the license application and$35.00 payment,the City of Yeim 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
I�I NEW BUSINESS � NAME CHANGElMAILING ADDRESS CHANGE ONLY
DATE N�Qy �1.� �LO I L�
BUSINESS NAME ��'Gl,(���� �(� �'f�lA r Vne�
NATURE OF BUSINESS �.CI�L�^ � 'i�S�r lA_r C�AY� l
BUSINESS LOCATION ADDRESS � I -1 � ��U i�Y�C7 1 1 IZ� Se '1�l�"1
MAILING ADDRESS q I�� i?�t�f'Ylel i 1� 5� y�ht ��� ��5 q�
ANTICIPATED OPENING DATE Sl.l�� �O I�
DAYS 8�HOURS OF OPERATION i,U�h `�c��,l "�'� 7�(�lY1�Qti t�f� �\OUfS I�(�K
OWNER(S) Y'(7►Cf 1C1� �c��.,(�YIC � ��J4'��5 (_LJ11�P Z� �
Birthdate C�.�IO y ( ��`��
Address PO �(JX -I Z-`' f�G(�Ni e T �J�' q7'�,��D
/� City State Zip
TELEPHONE �� ��JF�' LI�J(� �Cr� ��I��- GY���`J
(Business) (Home/Emergency)
CONTRACTOR'S REGISTRATION NO.
(If applicable)
THURSTON CO. HEALTH APPROVAL NO.
STATE OF WASHI TON MASTER BUSINESS LICENSE NO. (UBI) (.�3 3R��PU
Signatur L- Date � / �
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1���
CITY OF YELM
BUSINESS LICENSE APPIICATION
�0/13
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Page 1 of 1
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��ate I�usin��� �'t���vrds I���ta���e Det�il
TAX REGISTRATION NO: 603399168 ACCUUNT QPENED: 07/O1�'2014 12:OQ:OQ AI`7
UBI: 603399168 ACCUUNT CL05ED: OPEN
ENTITY NAh1E: GARDEN TO G�URMET LLC
BUSINESS NAP1E:
MAILING ADDRE55: BUSINE55 LUCATION:
9144 BURNETT RQ SE 9144 BURNETT RD SE
YELM,WA 98597-8488 YELM,WA 98597-8488
ENTITY TYPE: LIMITED IIABILITY RESELLER PERMIT ND: N,�A
PERMIT EFFECTIVE: N�'A
NAICS CODE: 722511 PERMIT E7{PIRES: N/'A
NAICS DEFINITIUN: FUIL-SERYICE RESTAURANTS
FC�R N�N-G(�MMER�IAL USE �NLY
05 f 30�2014 4:07 PM
http://dor.wa.gov/imagesBRDImage.aspx?tra=s0e3 m4jnD932IEOg02Yb1t4B20NzkkU... O S/30/2014
4�f TH�A'�,9� Ci ty o f Ye l rn
4 Rf
Public Worhs Department
105 Yelm Aven�e West
Yel�n, WA 98597
YELM
WASNINGTON
Date: �� 7�
Property Address: j� ' �f ' -� G� ��!��7
' �i'Y G�G (C>�.�c:''�
Business License Applicant: � � B�ll._ � � �yry►.� S , �-�
Dear Appiicant:
Section 13.04.220 YMC requires ali commercial buildinc ` �,,�,(; �� �� �
a Red `��1/� ��k�-�' \ �
uced Pressure Backflow Assembly (RPBA) device
Installation of a Reduced Pressure Backflow Assembly i: � T�� '
❑ Prior to approvai of your business license
❑ Within days of change of ownership �� ��J � �
� Not Applicable � �/ (� G�
�' /�
� � �
Confact Kevin R , City of Yelm Public �� �}�f�'
kevinr(a�ci.velm.wa.us for details on device o� � �Q �
requirements. �
i;.,F!? `y�J
Fats, oils, and greases entering the City of Yelm STEP se� � _r,�,�,,, �Q„ dUVersely
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-raor--to-a{�proual-ofi-your business licerjse __ --- - __ -- ____ - _- -.
❑ Within days of change of ownershi
❑ Not Applicable � � ���,�
,
Contact Jim Doty, Cify of Yelm Public Works (360) 458-8411
jimd(a�ci.yelm.wa.us for details,
Lori Mossman
From: Jim Doty
Sent: Thursday, June 05, 2014 8:36 AM
To: Lori Mossman ,
Cc: Kevin Ray
Subject: RE: 9144 Burnett Rd SE - RPBA
The Restaurant will need a grease trap. The owner will need to contact us for an inspection prior to approval, Sizing will
need to be done by an engineer or licensed plumber. Sizing will need to be approved prior to installation.
Jim Daty
Plant Manager
City of Yelm Water Reclamation Facility
931 N.P. Road
Mail:
1�5 Yelm Avenue W
Yelm, WA 98597
Ph. (360)458-8411
Fax. (360)458-8166 _ _ . . _.
From: Kevin Ray
Sent: Wednesday, June 04, 2014 2:04 PM
To: Jim Doty
Subject: FW: 9144 Burnett Rd SE - RPBA
Please respond to Lori's e-mail below.. Thanks
Kevin Ray
Public Works Field Supervisor
360-458-8406
901 Rhoton Rd SE
Yelm WA 98597
; ___ _ _ _ _ _ _
From: Lori Mossman
Sent: Wednesday, June 04, 2014 1:55 PM
To: Kevin Ray
Subject: RE: 9144 Burnett Rd SE - RPBA
Would it be alright to have a restaurant at that address? Do they need a grease trap?
_ _ __,__. _ __ _ _�._ __
__ __.__ _
From: Kevin Ray
Sent: Wednesday, June 04, 2014 12:53 PM
To: Lori Mossman
Subject: RE: 9144 Burnett Rd SE - RPBA
The address 9144 Burnet Rd se has an Reduced pressure backflow assembly.
Kevin Ray
Public Works Field Supervisor
360-458-8406
901 Rhoton Rd SE
Yelm WA 98597
1