20150299 Permit Pkg 09082015City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Applicant:
Name: CASA MIA
Address: 134 PRAIRE PARK
YELM WA 98597
Property Information:
Site Address: 11A PRAIRIF PARK RT NF
Assessor Parcel No.: 99002058849 Subdivision:
Contractor Information:
Name: CASA MIA
Address: TERRY COLE
134 PRAIRE PARK
YELM WA 98597
Contractor License No.:
Permit No.: 20150299
Issue Date: 9/08/2015
(Work must be completed within 180 days)
Phone: 400 -2277
Owner:
Lot:
Phone:
Expires: 0 /00 /0000
Project Information:
Project: OTHER SPECIAL EVENT
Description of Work: ANNIVERSARY BANNER SEPT 4 THRU SEPT 30, 2015
Sq. Ft. per floor: First Heat Type (Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item
SE
Contractor
CASA MIA
TOTAL FEES:
Applicant's /Affidavit:
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
Yelm regulations including those governing zoning and land subdivision, and in addition, all covenants,
easement and est ions f record. If applying as a contractor, I further certify that I am currently
registered in th State of WAshington.
Signature Date
Firm
Fees
$ 0.00
$ 0.00
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
SPECIAL EVENT/ TEMPORARY -USE
APPLICATION
Special Event Sign Permit (limited to 14 days, 4 tunes per calendar year)
Temporary Use (property owner permission fetter required)
(see REVERSE for regulations)
NAME OF PROJECT '1 rn,
APPLICANT /BUSINESS NAME C.
Mailing Address
City; State and ,Zip ,t `� �:?
Telephones EMAIL
City of Yelm Business License dumber
SITE OWNER
Mailing Address
City, State and Zip
Telephone EMAIL
SITE ADDRESSILOCATION
SITE PARCEL NUMBER
SUMMARY OF REQUEST
START DATE' -- , - 1 4- 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, 1 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 Pro�erty as reasonably necessary to process this application.
Signed Datp—
ROUTING: SPECIAL EVENT Building Section
TEMPORARY USE Planning Section Building Section
105 Yelm Avenue West
PO Box. 479
Yelm, WA 98597
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�71FD ,
SEP 08 2015
i
(360) 458 -3835
(360) 456 -3144 FAX
wUW-xi;yelm.wa.us
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