310 Railroad St NW (2)l
11/14/2013 THU 11:21 FAX
CITY OF YELM
105 Yelm Avenue W.
Yelm WA 93597
(360) 458 -8437 OFFICE
(360) 458 -4348 FAX
www.Ci.yelrn.wa.us
APPLICATION FOR
BUSINESS LICENSE
LFrICIAL USE ONI.Y'�
F-cc
Roc: By
G0111411 Dev :z-
In-W —_
f3lU�f 1] dpt.
Lcc Nu.
UpOn receipt of the license application and $35.00 payrnenl, the City of Yet"' will conduct an inspection of
the premiSQs for building and fire code conformance. Upon approval from the Yelin t3uildinq Department
Of said premises, the City Clerk's Offirc will process the applicalion and mail lic(inse to apphcar)t at
address listed below.
Application is hereby made for a Business License for the City of Yelrn
NEW BUSINESS ❑ NAME CHANGEIMAILING ADDRESS CHANG
DATE E ONLY
BUSIN
NATUkt OF BUSINESS
BUSINESS LOCATION ADDRESS
MAILING ADDRESS d �G, E/NR
ANTICIPATED OPENING DATE
DAYS & HOURS OF OPERATION
OWNER(S)
GL(C1�'� �h f, �/J G{ gm T
Birthdate ��l
Address
TELEPHONE Ot� ty _ fate
(Business) (I- lome /[mergency)
CONTRACTOR'S REGISTRATION NO.
THURSTON CO. HEALTH APPROVAL NO-
applicable
ro 111
Zip
STATE OF WASHINGTON MASTER BUSINESS LICENSE NO. (UBI)
1 01-11
Signature llfk V,
_ Dale—////S /43
CITY OF YELM
BUSINESS LICENSE APPLICATION
Eft. 5 /0e
®033/033