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If the application is made on behalf of a partnership, please subrnit 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 />Emergency contact name(s) and phone number(s) that can be contacted during the <br />event: <br />H 509.899.2002 <br />Name Phone Number <br />John Jensen 425.495.5955 <br />Name Phone Number <br />WRITTEN PERMISSION TO ENTER EVENT SITE <br />l/We hereby permit law enforcernent 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 />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 />familiaized myself with County requirements. l/We agree that either my designated <br />agent or If 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 wi <br />forth in Code may be deemed a gross misd <br />violations are crimes under RCW. <br />Hilarv Jensen <br />Applicant Name (Print) <br />Applicant Name (Print) <br />th the rules <br />emeanor and <br />Applicant <br />and conditions set <br />or narcotics <br />a <br />Applicant Signafure <br />KITTITAS COUNTY COURTIJOUSE 205 WEST 5.I., SUITE I08 ELLENSBURG, wA 98926 <br />(s09)962-7s08 FAX (509) 962-'7679 <br />www.co.kittitas.wa.us