201 Tahoma Blvd SW, Ste 208 � �� CITY OF YELM OFFiCIALUSEONLY
��0� THF I�9� 105 Yelm Ave. W. ReC BY35.00 2
`Q 9r Yelm, WA 98597 Comm Dev. ept. �
4' � (360) 458-8437 OFFICE Bldg Dept. ��` � »
� � (360) 458-4348 FAX
Insp.Date
www.ci.yelm.wa.us
Lic.No.
YELM APPLICATION FOR
WASHINGTON BUSINESS LICENSE
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 1-�t'g
DATE � � � - ���
BUSINESS NAME �� � ������ L���L� W�.Q�� r Q I��
NATURE OF BUSINESS ,Y �.�-L��-�����
BUSINESS LOCATION ADDRESS � \ ` CK.�� 1�� �\�i �� �? lll� �
MAILING ADDRESS �� l�3 t.�����1 �� OVt;� �l�-- I,lr� , �Ul�l�v�� ��� ��j���
EMAIL ADDRESS ���L��v�� '° �.�L��-� � ���
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ANTICIPATED OPENING DATE uV�d�`� V�.� � ` �L'� `� ��-'��t�- �5� ' `X`�:.
�- r� �� �.!`. .
DAYS 8�HOURS OF OPERATION N,�> ' '� V��' �
OWNER(S) ��►��G� t!i ` 1�� �/��'� 6�'/,�1,-� 4�Z'�- �����
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Addcess ����2 �jLa�G� L,��Z �����,�- +�-w"\ ��c��°�1n'y'J` � c�
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TELEPHONE�i�tiC�� `I V'�J° ��:7'�?5 �j�(� �?�l� ✓I �-�� � ��>
(Business} (Home/Emergency) y
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CONTRACTOR'S REGISTRATION NO.
(If applicable)
THURSTON CO. HEALTH APPROVAL NO.
STATE OF WASHINGTON MASTER BUSINESS LICENSE NO. (UBI)�G (;� �� � l�'��
(� 3
Signature Date
� �� � �
4�� TN,�p�'� Ci ty a f Ye l m
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Public Works Department
105 Yelm Auenue West
Yelm, WA 98597
YELM
wasH�NCroN
Date: -����
Property Address: Q � �j� ✓(� • Z� (�"
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Business License Appiicant: �(�� ,SS
Dear Appficant:
Section 13.04.220 YMC requires all commerciai buildings and irrigaiion systems to have
a Reduced Pressure Backflow Assembly (RPBA) device installed on the water services.
Installation of a Reduced Pressure Backflow Assembly is required:
❑ Prior to approvaf of your business license
❑ Within days of change of ownership
� Not Applicabi
Coni`act Kevin Ray, City of Yelm Public Works (360J 458-8410
kevinr(a�ci.�elm.wa.us for details on device options and inspection
requirements.
Fats, oils, and greases entering the City of Yelm STEP sewer system can adversely
affect the operation of the pfant and the City requires all appropriate measures to avoid
fafic nilc anr� yro�sos fi vi i i ^c�i�ci ii iy ii ie �ysier�i. Seciion i 3.vis.v9u Yeim iv�unicipai
Code requires an appropriately sized grease interceptor to be installed prior to the
STEP tank.
Installation of a Grease Interceptor is required:
� �rio� to approvai oT your business (icense
❑ Within days of change of ownership
l,� Not Applicable �
Confact Jim Doty, City of Ye/m Public Works (360) 458-8411
limd(c�ci.yelm.wa.us for details.
,