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821s1,t2823 L7:L8 589s655485 MAILNMORE PAGE A3/AE <br />If the application is mad.e on behal-f of a partnership, please submit full names with their <br />address for a period of six months prior to the date of <br />the location of principal office or place of business of such <br />residence and post office <br />application together with <br />corporation. <br />Ernergenry contact name(s) and phone nurnber(s) that can be corrtacted dwlng the <br />fo?-Q{ / -Q 7R <br />N <br />k <br />Phone Number <br />,D q.?o /-> t +# <br />Name Phone Nurnber <br />VVTilTTEN PERMISSION TO ENTER EVENT SITE <br />I/We hereby permit law enlorcement and/or County officials to entet 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 />corurection with this Event Application, <br />SWORN STATEMENT OF COMPTIANCE <br />I/We hereby acknowledge that I/We have read Kittitas County Code, have <br />familiarlzed mysell with County requirements. I/We agree that either my designated <br />agent or I/we shall be on site at all times and shall be responsible for the operation of <br />the event and for compliance with all iegal requirements in connection with this event- <br />I/Werrnderstand that failure to comply with the tules, regulations and conditions set <br />forth in Code may be deemed a gros$ misdemearror and that drug or narcotics <br />violations are sirnes under RCW. <br />Fn"^k P,.*-1,, <br />Applicant Signature <br />ApplicantName (Print)Applicant Signature <br />KITTITAS COUNTY C0URTHOUSE ' 205 wEsr s" sutTE 10$ ELLENSBURGT wr198926 <br />(509) 962-?so8 FAX (soe] e6z-76'19 <br />www.ca. kittitas. era.u€