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Home My WebLink AboutWA State Sporting Clay EventKittitas 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 ath!W://www.co.kittitas.wa.us/bocZcoun!ycode/titleO5-asp Event Inf ormation Name of event: Washington State Sporting Clays Championship 2018 Date(s) of event: September 20 21 22 23 2018 Hours of operation: 7:00 a.m. - 7,00 p.m. Description of the event:_ Competitive Sporting Clan competition, sanctioned by Washin ton State Sporfing SportingClays Association Has this event taken place before? Yes W Dates: Estimated attendance: 250 participants _ How is your event being publicized? Face Book, Winscore website Flyers at local clubs and Wshin ton State SpDrting SportingClays Association website . Please attach any flyers, posters, etc. with your application submission. Contact Information Name of the organizer/ contact person Richard Hoyt Address: PO Box 814 S. Cie Elum WA 98943 Phone number(s): 425 281-0749 Email address: _rick rick@hardline-construction.com Date of birth of applicant: 11 /8/74 MAR 14 Ol Pj K1TTITAS COUNTY COURTHOUSE • 205 WEST 5`s, SUITE 108 - ELLENS BURG, WA 98926 (509) 962-7508 - FAX(509)962-7679 www. col itti tas. wa.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: Jeff Daub 206 819-4763 Name Phone Number Misty Wicks 509 304-5002 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 t Gig or narcotics violations are crimes under RCW. Richard Hoyt Applicant Name (Print) Applicant ignature Applicant Name (Print) Applicant Signature KITITTAS COUNTY COURTHOUSE 205 WEST 5"', SUITE 108 ELLENSBURG, WA 98926 (509) 962-7508 . FAX (509) 962-7679 www.co.kittitas.waus Kittitas County, Washington BOARD of COUNTY COMMISSIONERS ti1171IA.tilt q S[7 Fire Safety 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 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?Z. No 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 hM. /www.co.kittitas.wa.uslhealth food.asp? - If yes, please submit an application for exemption from permit and proof of food handlers braining 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 orgaiiization 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. c o, k ittitas. wa, us Are there permanent or fixed bathroom facilities already available at the location of the event? Yes V 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 51h , SUITE 108 - ELLENSBURG, WA 98926 (509) 962-7508 • FAX (509) 962-7679 www,co.kittitas.wa us Kittitas County, Washington BOARD of COUNTY COMMISSIONERS Law Enforcement/Security RMergency Medical Services Will there be security on site during the event? Yes VO 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? Vs No 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? Vs No If yes, please provide documentation on how the traffic control will be addressed. \,j e- L,uil( hOQ+_-, 02, J'p+copl-e on LoheAe 4-o P9_V_Ir. Will there be off-site parking? Ys No If yes, please provide the location and a parking plan. 2l000 "P& sc.,o P8 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? Y/s No 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'h, SUITE 108 - ELLENSBURG, WA 98926 (509) 962-7508 - FAX (509) 962-7679 www.colittitas.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. 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 l6 KITTITAS COUNTY COURTHOUSE - 205 WEST 5h, SUITE 108 - ELLENSBURG, WA 98926 (509) 962-7508 - FAX (509) 962-7679 www, co.kittitas.wa. us Kittitas County, Washington BOARD of COUNTY COMMISSIONERS Garbage&ecycling Do you have a plan for garbage and recycling? Vs 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 and endorsements, specifically naming "Kittitas County" as an insured? Vs No A copy of the Certificate of Insurance amd endorsements 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 $2,000,00.0.00 aggregate coverage. This insurance must apply first and on a primary non-contributing basis hi relation to any other insurance or self-insurance available to Kittitas County. Penal Bond - Bond of Indemnity 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- 5,000.00 Penal Bond -Bond of Indemnity with your Event Application? Vs No 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. Counly Filin s and Registration Is there a cost to attend the event? Y/s No How much are you charging to attend your event? $600 per person. KITTITAS COUNTY COURTHOUSE • 205 WEST 5", SUITE t08 • ELLENSBURG, WA 98926 (509) 962-7508 FAX (509) 962-7679 www.co.kittitas.wa.us r, Sj �. J� t c O O e: O C f O O OL 03 ` L -, Pon Subject: Updated Before making our dream of Lost Pair Ranch into a reality, we knew we would have to go through the proper channels. This was going to be a special events sporting clay venue that would be held on 35 acres of our 160 acres of private land. Last spring (2017)- we started the process of putting together a very detailed and careful plan of our proposed 1st event. It was going to be called the Fall Sporting Classic. We submitted an application and fee to Kittitas County along with our detailed plan which included maps of the property, emergency plan, on site EMT, portable toilets, garbage/recycling, parking, camping, and food handling licenses. Our goal for the Fall Sporting Classic was to bring in 100 shooters. Shortly after the application was submitted we received a refund of our application fee and a letter stating we did not need a permit to host this event on our private property until the number of people reached 300. As you can imagine we were quite excitedl Our event was a huge success and we ended up hosting 97 shooters. After hearing the exciting news from the county we applied to be the next venue to host the 2018 Washington State Sporting Clay Championship. The Washington State Sporting Clay Association voted on it and it was awarded to us. We were ecstatic! Since we had the green light from the county and from WSCA it was full speed ahead. Many hours have been spent Firewising our property. Here is a list of just some of the items we have already purchased (out of our own pockets) for this special event: $35,000.16 Mec trap machines $5,200. Trophies $2000. Batteries $735. Insurance policy $500. Long range receivers $300. Solar panels Volunteers from all over the state have attended numerous weekend work parties including Many UKC residents. They have spent countless hours of back breaking work over the last year in preparation of this event. Sponsorships are in place. Entrants have put deposits down, purchased airline tickets and reserved hotels. Some of the top professional shooters from across the country plan to attend. This is a BIG DEAL! All neighbors who share a property line have all been contacted and know our plan. The approximate number of shooters for the 2018 State Championship is between 150-200 plus spouses. Our goal is to host 2 smaller events consisting of a one day shoot (5 hours of shooting) and 2 larger events consisting of a 3-4 day shoot (8 hours of shooting). We hope you will take all of this into consideration. Thank you, Lost Pair Ranch Sent from my iPad Voucher Kittitas County, Washington Claimant: C3790 - HOYT, RICHARD PO BOX 814 SOUTH CLE ELUM, WA 98943 FDate I Invoice # Description 6/14/2017 2017-2555 SPECIAL EVENT APPLICATION REFUND Warrant #: Run Date: 6/19/2017 Voucher Total: $200.00 Budget Code Amount Invoice Total 001-1632171 $200.00 $200.00 Comments: THIS IS REIMBURSEMENT FOR THE FALL SPORTING CLASSIC SPECIAL EVENT APPLICATION I, the undersigned, do hereby certify under penalty of perjury, that the materials have been fumished, the services rendered, or the labor performed as described herein, and that the claim is a just due and unpaid obligation against Kittitas County and that I am authorized to authenticate and certify to said claim. Prepared by: Mandy Buchholz, DEPUTY CLERK II. 06/14/2017 9:42 AM Copy: 2 REGISTERED SPORTING CLAYS SHOOT CERTIFICATE THIS IS TO CERTIFY that the NSCA affiliated club listed below has received official approval to hold a registered SPORTING CLAY tournament on the dates shown. This certificate is issued with the understanding: 1. The shoot will be conducted in accordance with the rules of the NSCA 2. Results will be reported to Headquarters within fifteen (15) days of the event, or a $25 delinquent fee will be assessed. 3. If the shoot is not held, Headquarters will be promptly notified. 54383 LOST PAIR RANCH RICHARD HOYT PO BOX 814 SOUTH CLE ELUM, WA 98943 -549915 WASHINGTON STATE CHAMPIONSHIP Sep 20 - 23, 2018 5/10/2018 ruu,aka.sy Public Health Washington State Food Worker Card /l n vard fM 05HOM8 to 05/9oMM Heel► officer Koh. H..ft 1201005MS&iP4UW1 TRANSACTION RECORD =_ TPC ONLINE FOOD CARDS 3629 S D ST MAILSTOP 006 TACOMA, WA 98418 United States WWW.TPCHD.ORG TYPE: Purchase ACCT: Visa $ 10.00 USD CARDHOLDER NAME: MISTY WICKS CARD NUMBER 8464 DATE/TIME : May 10, 2018 11:23:55 REFERENCE # :0010011357M AUTHOR. # :980589 TRANS. REF. :2590827 Approved - Thank You Please retain this copy for your records. Cardholder will pay above amount to card issuer pursuant to cardholder agreement. Do it Right, Serve it Safe httpsi/www.foodworkercard_wa.gov/payments/PrintCard 1/1 SrrATES or, 111-Alaton� ~ qn Secretary o State I, KIM WYMAN, Secretary of State of the State of Washington and custodian of its seal, hereby issue this CERTIFICATE OF FORMATION to LOST PAIR RANCH, LLC a/an WA Limited Liability Company. Charter documents are effective on the date indicated below. Date: 9/15/2017 UBI Number: 604-170-770 STA 71 Given under my hand and the Seal of the State y of Washington at Olympia, the State Capital a 1I� Secretary State 4D Kim Wyman, of X589 Date Issued: 9/19/2017 1944 "1 LOST PAIR RANCH, LLC PO BOX 814 SOUTH CLE ELUM WA 98943-0814 .J. � 8TA7g STATE OF WASHINGTON Limited Liability Company LOST PAIR RANCH, LLC 3900 PASCO RD CLE ELUM, WA 98922-9337 TAX REGISTRATION - ACTIVE DETACH BEFM POSTING .._ BUSINESS LICENSE Unified Business ID M 604170770 Business ID M 001 Location: 0001 This document lists the registrations, endorsements, and licenses authorized for the business named above. By accepting this document, the licensee certifies the information on the application % was complete, true, and accurate to the best of his or her knowledge, and that business will be conducted in compliance with all applicable Washington state, county, and city regulations. Director, Department of Revenue 10451 Gulf Boulevard, Treasure Island, Florida 33706-4814 CERTIFICATE OF COVERAGE CERTIFICATE NO: NGC 2917 -00 This document forms a part of Master Commercial General Liability Policy Number GGL01001 issued to NATIONAL SKEET SHOOTING ASSOCIATION & NATIONAL SPORTING CLAYS ASSOCIATION (NSSA-NSCA) ADDITIONAL INSURED/ MEMBERCLUB AGENT: LOST PAIR RANCH, LLC Sportsman's Insurance Agency, Inc. P.O. BOX 814 1364 North US 1, Suite 503 SOUTH CLE ELUM WA 98943-0814 Ormond Beach, FL 32174 www.siai.net POLICY PERIOD FROM 3/25/2018 TO 3/25/2019 1-800-925-7767 12:01 AM Standard Time at the address of the Insured Agent Number: SPORTM LIMITS OF INSURANCE General Aggregate Limit (Other than Products -Completed Operations) NONE Products -Completed Operations Aggregate Limit $1,000,000 Personal and Advertising Injury Limit $1,000,000 Each Occurrence Limit $1,000,000 Damage to Premises Rented to You Limit .$ 100,000 Any One Premises Medical Expense Limit $ 10.000 Any One Person Total Commercial General Liability Premium $550,00 Minimum Earned Commercial General Liability Premium $550 ADDITIONAL OPTIONAL COVERAGES - — Hired Auto and Non -Owned Auto Liability and/or Liquor Liability Coverage Occurrence Form ' If fig, l w and a prie(J,_ Hired / Nonowned Autos only - Per Endorsement form GGL99.003 1001 X - Hired Auto and Non -Owned Auto Liability NOT Selected $185.00 Liquor Liability Coverage - Occurrence Form - $1,000,000 Each Common Cause; $1,000,000 Aggregate - Per Form CGO033 1001 X - Liquor Liability Coverage NOT Selected It is hereby understood and agreed that the above additional optional coverages are excluded and do not apply to any excess liability coverages if excess general liablity is purchased. _ POLICY FORMS AND ENDORSEMENTS ATTACHED ip IME MAS ELR POfJCY GGL99.001 1001; GGL99.001E 1001; CL175 0286; CG0001 1001; IL0168 0101; IL0021 0498; CG2646 0499; CG2639 0499; NSSAGC1 0402; NSSAGC2 0402; CG2011 0196; IL0017 1198; CG2002 1185; CG2026 1185; CGO033 1001; CGO103 1000; CG3107 0200 & CGO057 0999; GGL99.003 1001 OPTIONAL EXCESS COMMERCIAL GENERAL LIABILITY COVERAGE _ _ if selected bsjs�►tvv_�sl�.A�mitlm-i-s.-ir�clf�ated� Excess Liability - Excess General Liability applies separately to the above listed member providing a limit of coverage NOT Selected in excess of the limits of the Master Policy, subject to an annual aggregate limit of coverage NOT Selected X - Excess Coverage NOT Selected March 28, 2018 Date Total Premium, subject to audit $735.00 AdthorizedSignature SHOULD THE ABOVE DESCRIBED POLICY BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE MASTER POLICY PROVISIONS. FMPNSSAGC 072013 Page 1 of 1 Kittitas County Office Of The Treasurer Brett Wachsmith, Treasurer 205 W 519L Avenue, Suite 102 Ellensburg, Wa 98926 Phone (509) 962-7535 Fax (509) 933-8212 Cash Receipts Receipt Number: 2018-2991 Date: 05/14/2018 Received From: MANDY BUCHHOLZ - DEPUTY CLERK OF THE BOARD 11 Check Amount: $200.00 Cash Amount: $0.00 Other Amount: $0.00 Total Amount: $200.00 Deputy: AMYC Receipt Type: CHK Template: Comments: CSR 2018-2196 SPECIAL EVENT APPLICATION FEE FOR WASHINGTON STATE SPORTING CLAYS CHAMPIONSHIP 2018 FundCode GlCode 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