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KITTITAS COUNTY F'RE À{ARSH AL'S OFF'TCE4 j I N. Ruby St., Sujre 2, Ellensburg ,WA 9g926 <br />office (509) 962_?6s7 Fax (509) 962_7682 <br />FÍre llfarshaÌ'n Speeial EvemÉlÄsser,nbtry,e perÌnf f <br />& Event Permit <br />Pbyical locatiol of Event: <br />Mailíng Àdùoss <br />n <br />Title ofElrnt:tÞ ic-È <br />f satP:dts Dri(L,W Efu,N N,4 %149- E Indoors pl/outdoors <br />Pùore #:jq .73f D C:cllfl: <br />City 2,5+5G <br />zip <br />3Þl <br />Á.pplieatíon Date:tl Initíat E Renewal <br />Dales/T¡mes ofEvent: l- <br />Evo¡t Coordinåtor <br />ft (Permanent) spccircureofBuildìog: <br />Pþ!icar <br />Pbonc #; <br />Cell#: <br />MÊìlioS. <br />ci.ty <br />ßm¡it:$ Zrp <br />Phonc #: <br />CgIJ#: <br />eiláing <br />crry F¡.il:sr 7-tD <br />SIJN:.tiról'¡:TIIE;II'ED:TTIU:ERI:SATSpecñcofDercrl¡Òdon O¡leradonÆvent:for(Requtred both pefmits) <br />FoodrBeverage?NO Alcohol Served?NO Live Entertainment?NOSecurity On Site?NO Tene? #of yEs <br />NOStages? #of I <br />a', Þo1.b11. b5Õ <br />Phone #: <br />Energency C-o¡tacl: <br />Aîe¡ }loun:Phone #:q., <br />P¡int Name:e <br />A v D <br />Owner /Authorized Agent <br />valid <br />toagree \¡/ith allcomply requrements re¡ated to thistogranttheKittitasFireCountyMarshal,s Ofiñce thepermitforapplication,the ofpu{pose suchmakinguntilrenewed,otrevoked,andexpired ls non- <br />Ve¡sio¡ 2009-2