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If the application is made on behalf of a partnership, please submit full names with their <br />residence and post office address for a period of six months prior to the date of <br />application together with the location of principal office or place of business of such <br />corporation, BuDu Racing. LLC (address is the same) <br />Emergency contact name(s) and phone number(s) that can be contacted during the <br />event: <br />Dea n na M u lie r :::==2:.=0-=-6---"'9::=:2-=-0--=3:=9-=.;83""--___ _ <br />Name Phone Number <br />Rory Muller 253-334-4433 <br />Name Phone Number <br />WRITTEN PERMISSION TO ENTER EVENT SITE <br />I/We hereby permit law enforcement and/ 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 County Code and <br />other applicable laws, and pursuant to my agreement and representations made in <br />connection with this Event Application, <br />SWORN STATEMENT OF COMPLIANCE <br />I/We hereby acknowledge that I/We have read Kittitas County Code, have <br />familiarized myself with County requirements, I/We agree that either my designated <br />agent or 1/ we shall be on site at all times and shall be responsible for the operation of <br />the event and for compliance with all legal requirements in connection with this event. <br />l/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 />vi ations are cr"es nder R W, <br />~VJ.-f-fI-~~~-~¢-? brn ,V) V'A-mILL t l-?v <br />Applicant Signature <br />Applicant Name (Print) Applicant Signature <br />KJTTITAS COUNTY COURTHOUSE· 2 05 WEST 5'h, SUITE lOR ELLENSBURG. WA 9R926 <br />(509) 962-7508 fAX (509) 962-7(-,79 <br />www.co.kittitas.\Va.us