Application Original Info
CITY OF YELM
PO Box 479
Yelm WA 98597
360-458-3244
OFFICIAL USE ONLY
Fee
Date Received
By
APPLlCA liON FOR
Special Uses Permit
File No.
Special Use Fee $500 00
Commercial Site Plan. $350.00 plus $50.00 per 1000 sq. ft. of gross floor area
Industrial Site Plan: $350.00 plus $150 per acre
(In addition, any professional service charges per Resolution #358)
A special use permit is an approval of a land use having slightly greater or unique impacts compared to
those of the uses permitted as a matter of right by city zoning Site plan review is a process for
reviewing the design of certain types of development. Site plan approval is required for all special uses.
Special uses require a hearing before the Yelm Planning Commission with City Council approval.
NAME OF PROJECT To rent from Damitio Insurance.
APPLICANT New Beginnings Foursquare Church.
Mailing Address PO Box 2127.
City, State and Zip Yelm WA 98597.
Telephone 160 4t)R~1??6 H()mp-~ 160 446.1?gg
OWNER Damitio Insurance.
Mailing Address 2903 Pacfic Ave.
City, State and Zip Olympia WA 98501 .
Telephone 360-352:7691
ENGINEER/ARCHITECT/OTHER nla
Mailing Address
City, State and Zip
Telephone
SUMMARY OF REQUEST To Rent.
PROPERTY DESCRIPTION
General Location Damitios Insurance Buildinq. West of Town.
Site Address 512 W.Yelm Ave. Yelm. Land Area (acres)
Section Township Range
Assessor's Tax Parcel Number J I 7 Pl.fJ 4! '50 I
Full legal description of subject property (attach s parate sheet if necessary)
CITY OF YELM
ds\c:\office\plandept.cc\apps\conduse.app
PLEASE ANSWER THE FOLLOWING QUESTIONS
ATTACH EXTRA PAGES IF NECESSARY
1 Does the design minimize conflicts with neighboring land uses? Explain.
We are no impact.
2. Is the site within 300 feet of any "critical areas" such as wetlands or streams? 1jA
3. What provisions will be made for storm water and/or flood control? At /A
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4 What provisions will be made for water supply and sewage disposal? ;VIA
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5. What provisions will be made for electrical power, natural gas, telephone and other utilities? -4-a--
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6 What provisions will be made for streets, access, and/or buses? AI/A
7 What provisions, if any, will be made for open space and/or recreation? !'11ft
8. What provisions will be made for schools and school children? iliff
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. I agree to pay all fees of the city which apply
to this application.
Signed Date
CITY OF YELM
ds\c:\office\plandept.cc\apps\canduse.app
Page 2
ATTACHMENTS.
Environmental Checklist (including $150 fee)
Mail labels (8 Y2 X 11 sheet) of Owners of Property
within 300 feet (include Assessor's Tax Parcel Numbers
and map.)
Vicinity map (8 Y2 X 11) showing nearby property,
streets, land uses, streams and other features
Copy of any covenants or restrictions that will apply
Grading plan for cuts and fills over 100 cubic yards
Eight copies of Site Plan at a scale not less than one inch
for fifty feet, showing
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CHECKLIST
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PLANNER USE ONLY
Checked by Date
Submitted
Missing
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Datum, north arrow, date and scale
The location of all existing and proposed structures,
including, but not limited to, buildings, fences, culverts,
bridges, roads and streets on the subject property
Wells and underground storage tanks within 200'
of property
The boundaries of the property proposed to
be developed.
All proposed and existing buildings and setback lines
All areas, if any, to be preserved as buffers or to be
dedicated to a public, private or community use or
for open space under the provisions of this or any
other city ordinance, information regarding percentage
of area covered, locations and general types
of landscaping
Conceptual Landscape Plan.
All existing and proposed easements.
The iocations of all existing and proposed utility
structures and lines.
A preliminary storm water drainage systems report and
layout for existing and proposed structures.
All means of vehicular and pedestrian ingress and
egress at the site and the size and location
of driveways, streets, and roads
The location and design of off-street parking areas
showing their size and locations of internal circulation
and parking spaces.
The location of all loading spaces, including, but not
limited to, truck loading platforms and loading docks.
Location and area, in square feet, of all signs
Topographic map or maps which delineate contours,
both existing and proposed, at intervals of two feet, and
which locate existing lakes, streams and forested areas, . 1/11
(or 5 foot if > 5% ) ~
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A reduced size copy of the site plan not larger than 11"X 17"
Tree and Vegetation Preservation Plan, per section 14 16 110
Design Guidelines Check-list.
CITY OF YELM
ds\c:\office\plandept.cc\apps\conduse.app
Page 3
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REceiPT No.137 21
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"'.it"''''FIVE HUNPRED DOLLARS & 00 CENTS
CR.
DATE 'REC. NO.
01.125/00 13721
AMOUNT
.500.00 CHECK
REF'NO
1963
RECEIVED FROM
WA98576
MISC.ELLANEOUS RECE.IPT
:A~NETTE
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CONDITIONAL USE PERMIT - NEW BEGINNINGS FOURSQUARE CHURCH
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CITY OF YElM
BUILDING DEPT.
Phone: (360) 458-8407j
Fax: (360) 458-8417
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Site Address I,)" If'"
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R Assessor's Parcel No, Lot Size (sq, ft./acres)
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~xlstlng Structures. If any'
8 Name i T ; ,^../ .$ Contact /hV Phone ( ) I"~ ' ,
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A Address I / ) " .. City I t. /i State Zip Code , ,
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License No. Exp, Yelm Bus, L1c, No. / .-
Description of Work 11/_.,1'1 { ,; (t' ~ / " ,. I ,(, OFFICIAL USE ONLY
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j j I PermitType:-
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Sq. Ft per floor (1 st) (2nd) Residential Sign
Sewer Septic Approval No, Commercial Other_
City Water Private Well Private System Shoreline Permit Y N
Heat' Electric Gas Other Sepa Exempt Y N
ITEM BASIS FOR FEE FEE Floor Plan Y N
....... Sets of Prints
Building Value } IJ ['
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Other Plumbing Permit #
WA. Sl BC, Fee (4,50 - New Const, Only) Mechanical Permit #
TOTAL FEE ;!,/ -'" Plan Check By
Minimum distance of structure from property lines: Issued By
Front to of Road Flnallnsp: I I
Side Side Rear Owner L & I Form
Assessor Floor Plan and Permit
Applicant's Affidavit:
I certify that I have read and examined the Information contained within the application and know the same to be true Submitted I I
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 a:0ctor. I further certify that I am a curren~y registered contract In the State of Washington,
..' .' ./1,.. J" Quarterlv Reports
SignatlJT~~;~::: /? .;; ~ /~ :/ L - ) II A~..-~ - Date 1:1 /1/ 9' C; Assessor I I
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Firm: TRPC I I