20150323 Permit Pkg 10292015City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Applicant:
Name: ROAD RUNNER EXPRESS
Address: 203 YELM AVE. WEST
YELM WA 98597
Property Information:
Site Address: 7nq VFI M AVI= W
Assessor Parcel No.: 85800300100
Contractor Information:
Name: ROAD RUNNER EXPRESS
Address: KATHERINE BROLLEIR
203 YELM AVE. WEST
YELM WA 98597
Contractor License No.:
Permit No.: 20150323
Issue Date: 10/2912015
(Work must be completed within 180 days)
Phone: 458 -9665
Owner:
Subdivision: Lot:
Phone:
Expires: 0 /00 /0000
Project Information:
Project: OTHER SPECIAL EVENT
Description of Work: ANNIVERSARY BASH. NOVEMBER 1 THRU NOVEMBER 14, 2015
Fees:
Item
SE
Contractor
ROAD RUNNER EXPRESS
TOTAL FEES:
Applicant' Affidavit:
I certify th t I have read and examined the information contained within the application and know the same
to be true nd correct. certify that the proposed structure is in conformity with all applicable City of
Yelm reg latio s cluding th a governing zoning and land subdivision, and in addition, all covenants,
easemen s a estrictions of cord. If applying as a contractor, I further certify that I am currently /-
registere in t State of W hington. �% h �r c
Signatur A - � r Date W
Firm
Fees
$ 0.00
$ 0.00
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
r
Z so 3 23
Pr-.4�q City of Yelm
Community Development Department
SPECIAL EVENT I TEMPORARY USE
YEL
APPLICATION
W%HINCTON
Special Event Sign Permit (limited to 14 days, 4 times per calendar year)
Temporary Use (property owner permission letter required)
(see REVERSE for regulations)
NAME OF PROJECT
APPLICANT /BUSINESS NAME
Mailing Address C) \ 4 `-2
• `M
City, State and Zip
Telephone ' U - 5 - q t EMAIL
City of Yelm Business License Number
SITE OWNER
Mailing Address
City, State and Zip CA (- r
Telephone " h ', EMAIL
SITE ADDRESS /LOCATION 1
SITE PARCEL NUMBER
SUMMARY OF REQUEST,
(A 6, 2D c V
START DATE c, 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 this application.
Signed Date 1 b ?; �t-j
n
ROUTING: SPECIAL EVENT Building Section
TEMPORARY USE Planning Section Building Section
105 Yelm Avenue West
Yelm, WA 98597
(360) 458 -3835
(360) 458 -3144 FAX
wwtvxi.yelm.wa.us