20160310 ROW Permit 08092016City of Yelm
Permit No. ��o
PUBLIC WORKS
901 Rhoton Rd NW
Application to Perform Work on
Yelm, %A 98597
Public Right of Way and /or Connect
Phone: 360 -458 -8406
to Utilities
FAX: 360 - 458 -8417
Proposed starting date of installation: 8/14/2016 ! Duration: 2 days
APPLICATION
The undersigned hereby makes application to: Tie the sidewalk from the property located at 405 Killion Ct NW
Yelm, WA 98597 known as Killion Court Apartments to the city sidewalk. The proposed work will be located at the
South side of the driveway into the apartments where it meets Killion Rd SE. The work would include new
concrete sidewalks and railings to meet federal ADA requirements.
Location of work: 405 Killion Ct NW, Yelm, WA 98597 at the south side of the driveway where the current side-
walk from the apartments stops just short of the city sidewalk.
I agree to perform the work in strict compliance with Yelm Municipal Code, Chapter the special
conditions enumerated herein and the attached conditions 1 have read and will adhere to the general provisions
applicable to pen-nits contained on this form.
The Public Works Department {360 -458 -8406) must be contacted for inspection 24 hours before work
commences or this permit -,% ill be void.
The Underground Utilities Coordinating Council (1- 800 - 424 -5555) must be contacted two (2) working days
before proceeding with any excavation associated with this permit.
Name: Matt Chantry for CAC 515 Preservation Portfolio Associates LLLP
Address: 2223 112th Ave NE ste 102, Bellevue, WA 98004 Phone: 425.454.8205 x 205
Proposed starting date of installation: 8/14/2016 ! Duration: 2 days
Date: 8/4/2016 Signature:
PERMIT REQUIREMENTS
For Official Use Only
Fee $
Issued
Fee Received $
Application Approval
Signature:
Receipt Number
To Be Completed By City
Permission is hereby granted to perform the above described work subject to the general provisions contained
on this form, and the following special conditions:
A bond in the amount of is required to insure compliance with the above
conditions, refundable upon satisfactory completion of work.
No work shall be done under this permit until the party or parties to whom it is granted shall have
communicated with and received instructions from:
Remarks:
First Inspection
Date:
Inspector Final Project
Completion Approval:
Date:
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City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Applicant:
Name: CAC 515
Address: 2223 112TH AVE NW, STE 102
BELLEVUE WA 98004
Property Information:
Site Address: A01; Kll_LION RD NW
Assessor Parcel No.: 21724120403
Contractor Information:
Name: CAC 515
Address: MATT CHANTRY
2223 112TH AVE NW, STE 102
BELLEVUE WA 98004
Subdivision:
Contractor License No.: Expires
Permit No.: 20160310
Issue Date: 0/00/0000
(Work must be completed within 180 days)
Phone: 425 - 454 -8205
Owner:
Phone:
Project Information:
Project: UTILITY
Description of Work: TIE SIDEWALK FROM PROPERTY LOCATED AT 405 KILLION CT NW
Sq. Ft. per floor: First Heat Type (Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item
RIGHT OF WAY
Contractor
CAC 515
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,
easements and restrictions of record. If applying as a contractor, I further certify that I am currently
registered in the State of Washington.
Signature Date
Firm
Lot:
Fees
$ 125.00
$ 125.00
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
Karen Bennett
From: Gary Carlson
Sent: Tuesday, August 09, 2016 3:33 PM
To: Karen Bennett
Subject: FW: Killion - Sidewalk Permit App
Attachments: 20160804 Perm itApp- Sidwalk Killion.pdf; 20160809 Perm itApp- SidewalkKiII ion Drawing. pdf
Karen,
Hard Copies are in your in box.
Gary
From: Matthew Chantry [ma i Ito: MattC @ShelterResourcesInc.com]
Sent: Tuesday, August 09, 2016 3:28 PM
To: Gary Carlson
Cc: Janel Salinas
Subject: Fwd: Killion - Sidewalk Permit App
Hi Gary:
Please see the attached application and drawing. The drawing indicates the location of the new sidewalk tying
into the city sidewalk in red. We will move the property sign back to accommodate the new sidewalk.
Please let me know if you have any questions. We would like to get the work started by the end of this week as
it will be doing other site work at the project this week.
Please let me know the cost of the permit and we'll get that paid ASAP.
Thanks!
Matt Chantry, MRED
Director of Asset Management
Shelter Resources, Inc.
2223 112th Avenue NE, Suite 102
Bellevue, WA 98004
(425) 454 -8205, ext.205
(425) 270 -8282 — Cell
(425) 455 -8546 — Fax
MattC .ShelterResourceslnc.com
www.ShelterResourcesinc.com
-- - - - - -- Original message -- - - - - --
From: Katherine Solan < katherines kshelterresourcesinc.com>
Date: 8/9/16 3:23 PM (GMT- 08:00)
To: Matthew Chantry <MattCkShelterResourceslnc.com>
Subject: Killion - Sidewalk Permit App