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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 o{ such <br />corporation" <br />Emergency contact name(s) and phone number(s) that can be contacted during the <br />event: <br />Mark Peterson (509)7284327 <br />Name <br />Alinia Sfrnm Tobin <br />Name Phone Number <br />WRITTEN PERMISSION TO ENTER EVENT SITE <br />l/We hereby permit law en{orcement and/or Counfy 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 />l/We hereby acknowledge that llWe have read Kittitas County Code, have <br />familiarized myself with County requirements, I/We agree that either my designated <br />agent or Irlwe 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 />Phone Number <br />f509)969-8683 <br />forth in Code may be deemed a gro6s <br />violations are crimes under RCW. <br />//"-* &rson <br />ApplicantName (Print) <br />Applicant Name (Print) <br />and or narcotics <br />Signature <br />KrrnrAs couN"y couRTHousE . 20s wEsr S, surrt tog EurNsBURc. wA 98926 <br />(509) 962-7508 FAX (509) 962-767e <br />www.oo,kiltiras,wa.us