20150196 Permit Pkg 05292015Applicant:
City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Permit No.: 20150196
Issue Date: 5/29/2015
(Work must be completed within 180 days)
Name: PIZZERIA LAGITANA
Phone: 360- 894 -0640
Address: 309 YELM AVE E
YELM WA 98597
Property Information:
Site Address: 309 YELM AVE E
Owner:
Assessor Parcel No.: 22719341901
Subdivision: Lot:
Contractor Information:
Name: PIZZERIA LAGITANA
Phone:
Address:
309 YELM AVE E
YELM WA 98597
Contractor License No.:
Expires: 0 /00 /0000
Project Information:
Project: OTHER SPECIAL EVENT
Description of Work: YELM PRAIRIE DAYS
PARADE SELLING COTTON CANDY AND SHAVED ICE, JUNE 25,
2015
Fees:
Item
SE
Contractor
PIZZERIA LAGITANA
TOTAL FEES:
Applic nt's Affidavit:
I certif that I have read and examined the information contained within the application and know the same
to be t ue arid- correct. I also certify that the proposed structure is in conformity with all applicable City of
Yelm egt4ations incl ding those governing zoning and land subdivision, and in addition, all covenants,
easenfients and restr tions of record. If applying as a contractor, I further certify that I am currently
regist re in the of Washington.
Signat re Date S- /
l
Firm
Fees
$ 0.00
$ 0.00
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
05128/2015 16:34 36091876667
REht;SR�hIDI P -AGE 011.01
Azv qk
City of Ye 1m
Community Development Department
SPECIAL EVENT I TEMPORARY USE
APPLICATION
Special Event Sign Permit (Ilmited to 14 days, 4 times per calendar year)
.Y Temporary Use (property owner permission letter required)
(see REVERSE for regulations)
NAME OF PROJl=CT
APPLICANT /BUSINESS NAME C4
Mailing Address__ 2121 y��
City, State and Zip kl,., U-)A cq a-S 17 _
Telephone 3a u - l 3l EMAIL ,ALL e--4 s t,
City of Yelm Business License Number
SITE OWNER ?;
Mailing Address fn
City, State and Zip �.-
Telephone__ EMAIL RdZOI, , X(YI
SITE ADDRESS /LOCATION
o
SITE PARCEL NUMBER
SUMMARY OF REQUEST
START DATE 7H c vi'5 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 reasonably necessary to process thi application. /
Signed r'I1 f srrCI%i C.l Date /�Q%
ROUTING: SPECIAL EVENT building Section
TEMPORARY USE Planning Section Building Section
105 Ye?lm Avenue West (860) 458-3835
Yelrn, WA 98597 (860) 458-3144 FAX
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