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If the application is made on behalf of a partnership, please stmt full names with their <br />residence and post office address for a period of sic months prior tO the dame of <br />application together -with the location of principal office or place of business of such <br />corporation. <br />Emergency contact name(S) and phone number(s) that can be contacted during the <br />T<-:1 <br />ent 3 I <br />ore bVi , ,L4 �b�� <br />1 <br />Name Phone <br />Name <br />Phone Number <br />WRMMN PERMISSION TO ENTER EVENT SITE <br />I/We hereby pernutlaw'enforcementand/or County officials to enter the site for which <br />the Event Application has been granted at the time of the event and up to five days <br />prior to the event for the purposes of inspecting and enforcement of Cmmty Code and <br />other applicable laws, and pmsvant to my agreement and representations made in <br />connection with this Event Application <br />SWORN STATEMUNT OF COM LL4LNCE <br />I/We hereby acknowledge that I/We have read Kittitas GD mty Code, have <br />fam�ari ed myself with County requirements. I/We agree that either my designated <br />agent or I/we sham. be on site at all time., and shall be responsible for the operation of <br />the event and for c01(npiiance with all legal requiremerds in cormect m with this event <br />I/ We understand that failure to comply with the rules, regulations and conditions set <br />forth in Code may be deemed a gross misdemeanor and that drug or narcotics <br />violations are cranes under-RCK <br />Applicant N a (PYint) <br />]-. en Ore- D o I hi n <br />Applicant Name t) <br />Applicant Signature <br />Applicant Sx�a e <br />KL3TCfASCOUMYCOURTHOUSE- 205WESTS", SUUT 109 - ELEMSBUMWA99926 <br />(509) 962-7509 . rAX (549) 962 7679 <br />www w.ldtht MwR.Us <br />