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The Patch Special Event Application
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09. September
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2022-09-20 10:00 AM - Commissioners' Agenda
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The Patch Special Event Application
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Last modified
9/15/2022 1:02:58 PM
Creation date
9/15/2022 1:02:31 PM
Metadata
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Meeting
Date
9/20/2022
Meeting title
Commissioners' Agenda
Location
Commissioners' Auditorium
Address
205 West 5th Room 109 - Ellensburg
Meeting type
Regular
Meeting document type
Supporting documentation
Supplemental fields
Item
Request to Approve a Special Event Application from Hillary Jensen for the Fall Festival at the Patch at Jensen Farms to be held September 24, 2022 - October 30, 2022
Order
2
Placement
Consent Agenda
Row ID
93904
Type
Special Event Application
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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. <br />Emergency contact name(s) and phone number(s) that can be contacted during the <br />event: <br />lllarv Jensen 509 899 2002 <br />Name <br />John Jensen <br />Phone Number <br />425.495.5955 <br />Name Phone Number <br />WRITTEN PERMISSION TO ENTER EVENT SITE <br />I/We hereby 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 />other applicable laws, and pursuant to my agreement and representations made in <br />connection with this Event Application. <br />SWORN STATEMENT OF COMPTIANCE <br />l/We hereby acknowledge that I/rNe have read Kittitas County Code, have <br />familiarized rnyself with County requirements. I/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 with the rules,conditions set <br />forth in Code may be deemed a gross misdemeanor and <br />violations are crimes under RCW. <br />Applicant Name (Print) <br />Applicant Name (Print) <br />narcotics <br />Applicant Signature <br />KITTITAS COTINTY coURTHoUSE . 205 WEST 5.I', SUITE IO8 ELLENSBURG, wA 98926 <br />(s09)962-7s08 FAX (509) 962-7679 <br />www.co.kittitas.wa.us
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