Laserfiche WebLink
If the application is made on behalf of a partnership, please submit full names with their <br />residence and p ost office address for a period of six months prior to the date of <br />application with the location of princi office or of business of such <br />corporation. <br />Emergency contact name(s) and phone number(s) that can be contacted during the <br />event: <br />Cliff Whitlock 209-598-2254 <br />Name <br />Viktoria Mever <br />Angie Rosen on behalf of the ALS Assoc. <br />Applicant Name (Print) <br />Applicant Name (PrinQ <br />Phone Number <br />425-941-6300 <br />Name Phone Number <br />WRITTEN PERMISSION TO ENTER EVENT SITE <br />I/We hereby permit law enforcement andf 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 />I/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 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 legal requirements in connection with this event. <br />l/We understand that failure to comply with the rules, 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 />Applicant Signature <br />Applicant Signature <br />KITTITAS COUNTY COURTHOUSE . 205 WEST 5.h, SUITE IO8 ELLENSBURG, WA 98926 <br />(509) 962-7508 FAX (509) 962-7679 <br />www.co.kiftitas.wa.us