20130295 Permit Pkg 08162013 �oF �'H�p� City of Yelm Permit No.: 20130295
9 Community Development Department Issue Date: 8/16/2013
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a (Work must be completed within 180 days)
Building Division
Phone: (360)458-8407
"""`"'"�'°" Fax: (360)458-3144
Applicant:
Name: WAL-MART Phone:
Address: 17100 SR 507
YELM WA 98597
Property Infortnation:
Site Address: 17100 STATE RT 507 SE owner:
Assessor Parcel No.: 64303101001 Subdivision: Lot:
Contractor Information:
Name: WAL-MART Phone:
Address:
17100 SR 507
YELM WA 98597
Contractor License No.: Expires: 0/00/0000
Project Information:
Project: OTHER SPECIAL EVENT
Description of Work: CAR SHOW,AUGUST 14 THRU AUGUST 18
Sq. Ft. per floor: First Heat Type(Electric,Gas, Other):
Second
Third
Garage
Basement
Fees:
Item Contractor Fees
SE WAL-MART $ 0.00
TOTAL FEES: S 0.00
Applicant's Affidavit: OFFICIAL USE ONLY
I certify that I have read and examined the information contained within the application and know the same
to be true and correct. I also certify that the proposed structure is in conformity with all applicable City of #Sets of Prints:
Yelm regulations including those governing zoning and land subdivision,and in addition,all covenants,
easements and restrictions of record. If applying as a contractor,I further certify that I am currently Final Inspection:
registered in the State of Washington.
Date:
Signature Date
By:
Firm
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�,o� T�p�` City of Yelm
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Community Deuelopment Department
SPECIAL EVENT/TEMPORAR Y USE
APPLICATION
YELM
WASMIN6TON
� Special Event Sign Permit (�imited to �a days, 4 times per calendar year)
Temporary Use (property owner permission letter required)
(see REVERSE for regulations)
NAME OF PROJECT ` 1�� ` �- '',
APPLICANT/BUSINESS NAME !.,�J�.l n��� � t
Mailing Address ��� V�� I <%c� �-�- �?�->- �d �� `� �
City, State and Zip �,i�i.� l� � G o��t�
Telephone(Ztor%1 �-��t� - S�D c,-� EMAIL
City of Yelm Business License Number
� SI TE OWNER w��� �-c-��-�--
Mailing Address � � '�' ���
City, State and Zip �\ W � �°
Telephone �� �-C�� � ��, ._ � - � EMAI L � C1(, ���c; I��I �-� �; �<<<S��z -�'��
SITE ADD ESS/ OCATION
S/TE PARCEL NUMBER
SUMMARY OF REQUEST
START DATE ( 1 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 prope , reasonably r� ce ary to process this application.
� ; ' ' - �/l��� �
Signed �� � Date
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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