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Gran Fondo Application
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06. June
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2021-06-15 10:00 AM - Commissioners' Agenda
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Gran Fondo Application
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Last modified
6/10/2021 1:40:47 PM
Creation date
6/10/2021 1:40:31 PM
Metadata
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Meeting
Date
6/15/2021
Meeting title
Commissioners' Agenda
Location
Commissioners' Auditorium
Address
205 West 5th Room 109 - Ellensburg
Meeting type
Regular
Meeting document type
Supporting documentation
Supplemental fields
Alpha Order
c
Item
Request to Approve a Special Event Application to Hold the Gran Fondo on June 19, 2021
Order
3
Placement
Consent Agenda
Row ID
77580
Type
Special Event Application
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If the application is made on behalf of a partorersl'rip, 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. <br />Emergencv confact narne(s) and phone number(s) that can be contacted during the <br />event: <br />Jake Maedke <br />Name <br />Karen Maedke <br />Phone Number <br />(50e) 760-3620 <br />Phone Number <br />WRITTEN PERMISSION TO ENTER EVENT SITE <br />I/We herebv permit law enforcement andf 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 />olher 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 Il\{e have read Kittitas County Code, have <br />farniliarized myself with Counly requirements. I/We agree lhat eithel my designatecl <br />agent or If we shall be on site at all times ancl shall be responsible for tl're operation of <br />the event and for compliance with all legai requirements in connection with this event <br />I/We understand that failure to comply with the rules, regulaiions and conditions set <br />forth in Code may be deemed a gross rnisdemeanor ancl that drug or narcotics <br />violations are crirnes under RCW <br />Name <br />Jake Maedke <br />Applicant Name (Print) <br />Karen Maedke <br />Applicant Name (Print) <br />KII-I'TTAS COUN'|Y COURTHOUSE . 205 WI]ST 5.h, SIJTIIJ I08 III-I,ENSBUItC. WA 98926 <br />(s09) 962-7508 FAX (509) 562-7679 <br />wury.co-kiItilas.rva. us
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