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If tIre application is made on behalf of a parf,relship please suburit fuIl nanres i,ltth 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 phorre number(s) that can be contactecl during the <br />event: <br />Mark Peterson (509)728-4327 <br />Name <br />Alicia Stromnne- Tsbin. <br />Phone Number(509)969,8683" <br />Name Phone iVumber <br />WRITTEN PERMISSION TO ENTER EVENT SITE <br />I/We herebl' per,nnit lawenforcement and/orCounty officials to enter the sile forn'hich <br />the Event Application has been grantecl 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 pursuantto my agreement and representations made in <br />connection with this Event Application. <br />SWOITN STATEMENT OF COMPLI,ANCE <br />l/We hereby acknowledge that I/We have read Kittitas County Code, have <br />familiarized myself with County requirements. I/We agree that either my designated <br />agent or l/we shall be on site at all times and shall be responsible for the operation of <br />the event iurcl for conrpliance with aII legal requirements in corurection with thir event. <br />I/We understand that failure to comply with the nrles, regulations and conditions set <br />forth in Code may be deemed a gross misdemeanor and that drug or narcotics <br />violations are crimes under RCW <br />Mark Pe'ter.son <br />Applicant Name (Print) <br />Alicia Stromme Tobin <br />Applicant Name (Print)Applicant <br />KirnrAs couNTy couRTLIousE . zos tt'Est is, sutrc l0B [LLE]isuuRG, wA t8926 <br />(509) 962-7508 . FAX(6Ary962"7619 <br />www,co,kittita.s.u'a.us