20170160 Application 03312017City of Yelm
PERMIT APPLICATION
YELM
WASNINCTON
Zt170100
Ministerial Permits Administrative Permits Quasi - judicial Permits
❑ Ministerial Site Plan Review ❑ Administrative Site Plan Review ❑ Binding Site Plan
❑ Boundary Line Adjustment ❑ Administrative Subdivision ❑ Planned Residential Dev.
❑ Home Occupation ❑ Administrative Variance ❑ Mixed Use Development
❑ Short Subdivision ❑ Variance
❑ Critical Area Exception
❑ Subdivision
❑ Special Use Permit
Business or development name: ,SANV � �jIJ Gel,
Description of proposed development: Qmpc- eA 0"� avi AAwl o-
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Applicant: w1� �nA1e, SIYI� Owner:WW& \ , �ALk�jj `
Address: tDb�� Address: Pb eC 03 Rq, W1 o
-r'A6VAVk, ION
Telephone: 25�- ��g -p5�� Telephone: L63"(,S�- 7
Email: Email:
Representative: Uf-' 0Aa C'ov\✓ kt- S�W
Mailing Address: 'Jou'Z7 A � ��
Telephone:3���'�C�� Email:
Property Address: V'� ��I��1 IV 4 qa '' I
p 1 ` `VVI V1T� 1 �6aGi's
Legal Description: r �L,� ��j L ` -,�101n� Z� 7 GX � 1N o y Wmv *3
Tax parcel number: I ,jy}�� �( Size of site: b 5D
Number of Lots: 1 W "V Gross Floor Area: , ,
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By submitting this application to the City of Yelm, you affirm that all answers, statements, and information
contained in and submitted with this application are complete and accurate to the best of your knowledge and
that you are the owner of the property or duly authorized by the owner to act on their behalf. Permission is
granted to representatives of the City to enter upon and inspect the property as reasonably ear rocess
the application. if 19R-gVM'%
mAR 3 1 2017