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Home My WebLink AboutGran Fondo ApplicationKittitas County, Washington BOARD of COUNTY COMMISSIONERS EVENT APPLICATION Thank you for your interest in holding a special event in Kittitas County. Please complete and return this application along with any other materials to the Kittitas County Board of Commissioners at least 60 days prior to the day upon the event is scheduled. Any misrepresentation in the application materials or deviation from the final agreed upon route and/or method of operation described may result in the immediate revocation of an issued permit. Specifics outlining Event Permits can be viewed at http://www.co.kittitas.wa.us/bgc/`cotiiiUcode/titleO5.asp Event Information Name of event:_ Gran Fondo Ellensburg Date(s) of event: 6-12-16 Hours of operation: 8:00 am -5-00 pm Description of the event: 88 mile bicycle ride Has this event taken place before? s No Dates: June 20 .2015 Estimated attendance: 100 How is your event being publicized? www.rideviciouscvcle.com Please attach any flyers, posters, etc. with your application submission. Contact Information Name of the organizer/ contact person: Jake Maedke FEB m- 8 7616 Address: 139 E SW Ephrata, WA 98823 Ist _ 2nd — 3rd_ Phone number()s : 509 750-0977 wiTTi7�as cu'��Iry BOARD of cornr��iSsiowrR ) �5._ Email address:�e hratabikes@gmall.com _ Date of birth of applicant: 10-14-77 KITTITAS COUNTY COURTHOUSE • 205 WEST 5"i, SUITE 108 , ELLENSBURG, WA 98926 (509) 962-7508 • FAX (509) 962-7679 www.co.kittitasma.us If the application is made on behalf of a partnership, please submit full names with their residence and post office address for a period of six months prior to the date of application together with the location of principal office or place of business of such corporation. Emergency contact name(s) and phone number(s) that can be contacted during the event: Jake Maedke (509) 750-0977 _. Name Phone Number Karen Maedke (509) 760-3620 _ Name Phone Number WRITTEN PERMISSION TO ENTER EVENT SITE I/ We hereby permit law enforcement and/or County officials to enter the site for which the Event Application has been granted at the time of the event and up to five days prior to the event for the purposes of inspecting and enforcement of County Code and other applicable laws, and pursuant to my agreement and representations made in connection with this Event Application. SWORN STATEMENT OF COMPLIANCE I/ We hereby acknowledge that I/ We have read Kittitas County Code, have familiarized myself with County requirements. I/ We agree that either my designated agent or I/we shall be on site at all times and shall be responsible for the operation of the event and for compliance with all legal requirements in connection with this event. I/ We understand that failure to comply with the rules, regulations and conditions set forth in Code may be deemed a gross misdemeanor and that dr r or narcotics violations are crimes under RCW. Jake Maedke Applicant Name (Print) Applicant S inature Applicant Name (Print) Applicant Signature KITTITAS COUNTY COURTHOUSE 205 WEST 5"', SUITE 108 • ELLENSBURG, WA 98926 (509) 962-7508 • FAX (509) 962-7679 www.co.kiffltaS.WaA1S Kittitas County, Washington BOARD of COUNTY COMMISSIONERS Fire Safetv and Protection If more than 50 people are expected at your event, you must complete a separate application process which can be obtained through the Kittitas County Fire Marshal's office. You may contact the Fire Marshal's office at 509-962-7000. Will there be a temporary structure erected for the event? Yes fir° If yes, you must attach a drawing including the dimensions. The structure may require an inspection by County staff prior to the event. Public Health/Environmental Health Will there be food served at the event? Yes 16 If no food will be served at the event then, no permit or application is required. If yes, is the food and beverage that you intend on preparing and serving at the event exempt from permit requirements http:/1www.co.kittitas. wa.us/health/food.asR? - If yes, please submit an application for exemption from permit and proof of food handlers training to the Kittitas County Public Health Department (KCPHD). If yes, and the food or beverage is not considered exempt from permit, then does the person or organization preparing and serving the food have a food service permit, temporary food service permit, or catering permit from KCPHD? - If yes, please provide a list of foods and beverages that you intend on having prepared and served at the event along with the name and phone number(s) of the permitted person or organization. If yes, and the person or organization preparing and serving the food does not already have a food service permit. - Then a temporary food service permit or catering permit will need to be acquired from KCPHD prior to the event. Please allow at least 2 weeks to complete the food service permitting process. KITTITAS COUNTY COURTHOUSE - 205 WEST 5", SUITE 108 • ELLENSBURG, WA 98926 (509) 962-7508 FAX (509) 962-7679 www.co.kittitasma.us Are there permanent or fixed bathroom facilities already available at the location of the event? Yes Vo If yes, please provide an estimated attendance for the event, a detailed map that identifies the name and address of the physical facility that will provide lavatory facilities for the event, quantity of toilette facilities available for each gender, and the distance from the event that patrons must walk. If no, please provide an estimated attendance for the event, specific information related to the number of portable restrooms that will be provided, the distance from the event that patrons must walk, and a service plan to ensure that sani-cans remain in a sanitary condition. You must include the location of the portable restrooms on a map/ diagram of the event. KITTITAS COUNTY COURTHOUSE • 205 WEST 5"i, SUITE 108 ELLENSBURG, WA 98926 (509) 962-7508 - FAX (509) 962-7679 www.co,.kittHas.wa.us Kittitas County, Washington BOARD of COUNTY COMMISSIONERS Law Enforcement/Securib fEmergency Medical Services Will there be security on site during the event? Yes V If yes, please provide a complete list of names and contact information for who will be providing the security. Will Emergency Medical Services (EMS) be on site during the event? Yes V If yes, please provide written verification from the providers. Will there be music, sound amplification or any other noise impacts? Yes I6 If yes, Kittitas County has a noise ordinance in effect (see County Code for details). If your event is scheduled for outside of the allowed time, you must submit a written letter to the Board of County Commissioners requesting a waiver and it must be included with your application materials. Will you have traffic control? Yes Vo If yes, please provide documentation on how the traffic control will be addressed. Will there be off-site parking? Yes ]'Y If yes, please provide the location and a parking plan. Will there be shuttle buses provided for attendees? Yes 16 If yes, provide a map of their route. Will there be alcohol served at the event? Yes 46 If yes, a State permit is required from the WA State Liquor Control Board and must submitted with your application materials. KITTITAS COUNTY COURTHOUSE • 205 WEST 5"i, SUITE 108 • ELLENSBURG, WA 98926 (509) 962-7508 FAX (509) 962-7679 www -co. ki tti tas. wa.us Kittitas County, Washington BOARD of COUNTY COMMISSIONERS Public Roads Will the event obstruct, interfere or require the closure and free use of any public road, street or right-of-way? Yes V6 If yes, please provide a detailed adequate traffic and detour plans at the time of submission of the application. Will there need to be road closure or detour signs posted? Yes V KITTITAS COUNTY COURTHOUSE - 205 WEST 5"', SUITE 108 - ELLENSBURG, WA 98926 (509) 962-7508 • FAX (509) 962-7679 www.co.kittitas;wa.us Kittitas County, Washington BOARD of COUNTY COMMISSIONERS IL Garba a ecycling Do you have a plan for garbage and recycling? �s No A written plan for garbage and recycling must be attached to your application materials. For questions or assistance contact the Kittitas County Solid Waste Department at 509-962-7542. Insurance Have you obtained a Certificate of Insurance, specifically naming "Kittitas County" as an insured? Yes 4(0 A copy of the Certificate of Insurance must be included with your application materials. Kittitas County must be named as an additional insured in the amount of $1,000,000.00 per occurrence and $2,000,000.00 aggregate coverage. Penal Bond - Bond of Indernnitv A $5,000.00 Penal Bond - Bond of Indemnity is required to be deposited with the County Treasurer to save and protect the streets, pavements, bridges, etc. from damage. The deposit or its balance will be returned once the event has been held and the Board of County Commissioners has certified no damage has been done and that the County has not incurred additional expenses Are you submitting a $5,000.00 Penal Bond - Bond of Indemnity with your Event Application? Yes Vo If no, you must request a letter in writing to the Board of County Commissioners requesting a waiver to the Penal Bond - Bond of Indemnity and outline the specific reasons why it should not be required of your event. County Filings and Registration Is there a cost to attend the event? Vs No How much are you charging to attend your event? $70 KITTITAS COUNTY COURTHOUSE - 205 WEST 5"', SUITE 108 ELLENSBURG, WA 98926 (509) 962-7508 • FAX (509) 962-7679 www,co, kitt i to s, wa. us EVENT Gran Fondo Ellensburg Vicious Cycle Events Medical Plan DATE June 12, 2016 1. Will there be an EMT or ambulance on site? Yes X No If not on site, how will emergency medical staff be notified? Pay Phone X Cell Phone Radio Other: . 2. Are there event staff or certified volunteers with Red Cross First Aid training? Yes If yes, what training? X Basic Advanced - Identify staff: Karen Maedke/Ruth Lamb 3. Is there a First Aid kit on site? X Yes No 4. Will police or security services be on site? Yes X No 5. Will emergency medical staff at event site be clearly identified? X Yes No 6. First aid and emergency medical stations identified? _ x ..__ Yes No 7. Does course design allow easy access for emergency vehicles? X Yes No 8. Describe emergency medical transportation? Ambulance 9. City/Location of nearest hospital: Kittitas valley Hospital- Ellensburg WA 10. Distance from event: 30 Miles 30 Minutes 11. Has hospital been notified of the event? X .... Yes No 12. Is emergency air transportation available? X Yes No Response time: NA Minutes 13. How will air transport be notified? X Phone Radio X EMT 14. What is the plan for suspending or postponing the event if a serious injury occurs? Riding will be suspended until the injured rider is safely removed from course NOTES: HOSPITAL PHONE NUMBER; 509-925-8472 AMBULANCE PHONE NUMBER: 509-962-7275 POLICE/SHERIFF PHONE NUMBER: 509-962-7527 ADDITIONAL INFORMATION: "Saq Wagon's" will be carrying a first aid kit as well as each of the "Aid Stations" No Gran Fondo Ellensburg: June 12, 2016 Course can be seen online at: http://ridewithgps.com/routes/6833060?privacy_code=gzktW4gsOqacWhZC Start heading west on Dry Creek Rd 0.0 mi Turn right onto US -97 N 3.3 mi Turn left onto McManamy Rd 3.3 mi Turn right onto WA -10 W 4.2 mi Turn left onto WA -10 WMA -970 W 19.5 mi Continue onto WA -903 Spur 21.7 mi Merge onto WA -903 22.0 mi Continue onto W 1st St 23.8 mi Turn left onto S Cle Elum Way 24.0 mi Turn right onto Madison Ave 24.9 mi Turn left onto 6th St 25.0 mi 6th St turns right and becomes Marie Rd 25.2 mi Continue onto Westside Rd 25.3 mi Turn right to stay on Westside Rd 27.3 mi Turn left onto Woods and Steele Rd 28.9 mi Turn left onto NF -4510 29.6 mi Slight left onto NF -3300 44.5 mi Slight right to stay on NF -3300 46.3 mi Slight right onto NF -135 51.9 mi Slight right onto NF -3300 54.3 mi Turn left onto NF -133 54.8 mi Turn right onto NF -119 56.7 mi Turn left onto NF -3350 58.7 mi Continue onto Westside Rd 65.2 mi Continue straight onto Mohar Rd 65.3 mi Turn right 66.8 mi Turn right onto Upper Peoh Point Rd 67.9 mi Continue onto Thorp Prairie Rd 73.1 mi Turn left onto E Taneum Rd 80.5 mi Turn right onto Thorp Hwy 83.2 mi Turn left onto Gladmar Rd 85.4 mi Turn Right onto Iron HorseTrail 85.6 mi Finish 88.4 mi January 13, 2016 Kittitas County Commissioners 205 West 5th, Suite 108 Ellensburg, WA 98926 RE: Requesting a waiver to the Penal Bond — Bond of Indemnity Dear Kittitas County Commissioners: On behalf of Vicious Cycle Events Inc., we are requesting a waiver to the $5000 Penal Bond - Bond of Indemnity. We don't anticipate any damage to any county roads during this Gran Fondo Ellensburg Bicycle Ride. We have done several bicycle rides throughout different counties in Washington and have had zero problems with damage. We have worked with Grant, Douglas, Chelan and Klickitat counties as well as the DOT and Department of Fish and Wildlife utilizing their roads for the purpose of these bicycle rides. There are between 100-200 riders on the road spread out over the course of approximately 7 hours for an 88 mile bike ride. All riders will be advised to obey all traffic laws. We appreciate your consideration. Sincerely, r Jake Maedke Vicious Cycle Events Inc. Vicious Cycle Events Inc. 139 E ST SW Ephrata, WA 98823 509-750-0977 January 13, 2016 Kittitas County Solid Waste Department 205 West 5th, Suite 108 Ellensburg, WA 98926 RE: Solid Waste Plan for Bicycle Event Dear Kittitas County Solid Waste Department: This letter is to inform you of our Garbage/Recycling plan for the Gran Fondo Ellensburg scheduled to take place on June 20th. All refuse generated from the Bicycle event will be picked up and disposed of by the event Director. There will be a follow vehicle that will be picking up refuse at the end of the event. Sincerely, Jake Maedke Vicious Cycle Events Inc. Vicious Cycle Events Inc. 139 E ST SW Ephrata, WA 98823 509-750-0977 ,o Kittitas County Office Of The Treasurer /.� Brett Wachsmith, Treasurer 205 W 5th Avenue, Suite 102 •--_-,,,,,, ,,.�_ Ellensburg, Wa 98926 Phone (509) 962-7535 Fax (509) 933-8212 Cash Receipts Receipt Number: 2016-836 Date: 02/08/2016 Received From: MANDY BUCHHOLZ DEPUTY CLERK OF THE BOARD -MA Check Amount: $200.00 Cash Amount: $0.00 Other Amount: $0.00 Total Amount: $200.00 Deputy: AMYC Receipt Type: CHK Template: Comments: CSR 2016-666 GRAN FONDO SPECIAL EVENT APPLICATION 6-12-16 FundCode G1Code Description Amount 001 1632171 SPECIAL EVENTS FEE $200.00 Total Amount: $200.00 Kittitas County Treasurer's Office Submitted By: AMY CZISKE (c) 2002 Cashtax All Rights Reserved www.balancedaction.com Mandy Buchholz From: Jake & Karen Maedke <ephratabikes@gmail.com> Sent: Monday, February 08, 2016 1:26 PM To: Kittitas County Commissioners Office Subject: Re: 2016 Gran Fondo Ellensburg bicycle ride Mandy - We will be getting the certificates of insurance once all of the entities/applications are filled out and sent in. The insurance is non-refundable, so we need to make sure that we have everyone's approval before acquiring it. We will get it to you as soon as possible. Karen Maedke On Mon, Feb 8, 2016 at 12:44 PM, Kittitas County Commissioners Office <bocc@co.kittitas.wa.us> wrote: Hello, Got your application today. Thank you... will you be getting the certificate of liability insurance sometime soon. I know our Prosecutor will not approve the event until that is available. Let me know, thank you! Mandy Buchholz (Robinson) Deputy Clerk of the Board Kittitas County Commissioners Office 205 West Fifth Street Suite #io8 Ellensburg, WA 98926 509-962-75o8 Phone 509-962-7679 Fax mandy.buchholz@co.kittitas.wa.us http://www.co.kittitas.wa.us/