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20140250 Permit Pkg 09122014 �o� �H�p�, City of Yelm Permit ►vo.: 20140250 o �� � Community Development Department Issue Date: 9/12/2014 � (Work must be completed within 180 days) Building Division Phone: (360)458-8407 L """",""°" Fax: (360)458-3144 Applicant: Name: STOMPING GROUNDS ESPRESSO Phone: 360-458-5288 Address: 1008 YELM HWY E YELM WA 98597 Property Information: site Address: 1008 YELM AVE E owner: Assessor Parcel No.: 22730110209 Subdivision: Lot: Contractor Information: Name: STOMPING GROUNDS ESPRESSO Phone: Address: 1008 YELM HWY E YELM WA 98597 Contractor License No.: Expires: 0/00/0000 Project Information: Project: OTHER SPECIAL EVENT Description of Work: ONE YEAR ANNIVERSARY Fees: Item Contractor Fees SE STOMPING GROUNDS ESPRESSO $ 0.00 TOTAL FEES: $ 0.00 Applican s Affidavit: OFFICIAL USE ONLY I certify t at I have read and examined the information contained within the application and know the same to be tru and correct Iso certify that the proposed structure is in conformity with all applicable City of #Sets of Prints: Yelm re ulations uding those governing zoning and land subdivision,and in addition,all covenants, easeme ts and strictio of record. If applyi as a contra r,I further ceRify that I am currently Final Inspection: registere in th tate Washington � (� ' Date: Signature a By: Firm �,o� T�p$�` Ci ty o f Ye Zm �'������ � �� °" Community Deuelopment Department SPECIAL EVENT/TEMPO�AR Y US� APPLICATION EL WASMIMGTON � Special Event Sign Permit(�imited to 14 days,4 times per calendar year) Temporary Use (property owner permission letter required) (see REVERSE for regulations) NAME OF PROJECT � t�'I���� C��I�'���/Y �.'t,� �U� APPLICANT/BUS/NESS NAME �� ' �1 ' �' '� � Mailing Address '� �' ` City, State and Zip � Cr� Telephone � �a EMAIL - t`l "LL I��� L City of Yelm Business License Number �'O� �1 ���� � . ��� SITE OWNER ' � � - �` ' � Mailing Address ZO -� �- `1 City, State and Zip VYl ��1 � ^ Telephone`� SS -1u�-- , EMAIL ' V _ l r� �-.�('1��.� � S/TE ADDR�.ES�LOCATION " - i L(�YYI SITE PARCEL NUMBER SUMM RY OF R QUEST '� � � r� � / ,\ �- . , - , � � � , START DATE � ��t END DATE 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 reasonahly\cessary to process this application. Signed ��� � � l 6, Date � ��� ��� ��� � ROUTING: SPECIAL EVENT Building Section TEMPORARY USE Planning Section Building Section 105 Yelm Auenue West (360) 458-3835 Yelm, WA 98597 (360) 458-3144 FAX www.ci.yelm.wa.us