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Home My WebLink AboutPumpkin Festival aka Huffman FarmsKittitas County, Washington BOARD oF COLTNTY 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. Ary misrepresentation in the a pplication materials or deviation from the final agreed upon immediate revoca route andf or rnethod of operation described may result in the tion of an issued perrnit. Specifics outlinin g Event Permits can be viewed at htto: / / www.co.kittitas.wa.rr / boc / countvcode / title05.asn Event Information Name of event: Pumpkin Festival Date(s)of event: Ooen 9125 and open Thurs-Sun throuqh 10131 Hours of op eration: 1Oam to 4pm Description of the event: U-pick pumpkin patch with all the fall fun (havrides, corn maze, pettinq zoo, concessions. activities and sho pptnq Has this event taken place before? G No Dates: Since 2013 Estirnated attendance: 9 000 How is your event being publicized? posters, word of mouth Social media radio, visitor quides, Please attach any flyers, posters, etc. utith your application submission, Contact Information Name of the organizer f contact person:Hila Jensen Address: 6181 Wilson Creek Rd AUG Z3 ',;il Phone nurnber(s)509.899.2002 ,.li tl Ii i r'rEmail address: Hilarv(Etheoa tchiensenfarms.com Date of birth of app licant: 111911974 KITTITA,S couNTy couRTIlousE 205 wEST 5'r', sutrE I08 ELLENSBURG. wn 98926 (s09) 962-7508 FAX (509) 962-7679 wr.lrv. co. k i ttitas. wa. u s If the application is made on behalf of a partnership, please subrnit 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: H 509.899.2002 Name Phone Number John Jensen 425.495.5955 Name Phone Number WRITTEN PERMISSION TO ENTER EVENT SITE l/We hereby permit law enforcernent andf 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 familiaized myself with County requirements. l/We agree that either my designated agent or If 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. l/We understand that failure to comply wi forth in Code may be deemed a gross misd violations are crimes under RCW. Hilarv Jensen Applicant Name (Print) Applicant Name (Print) th the rules emeanor and Applicant and conditions set or narcotics a Applicant Signafure KITTITAS COUNTY COURTIJOUSE 205 WEST 5.I., SUITE I08 ELLENSBURG, wA 98926 (s09)962-7s08 FAX (509) 962-'7679 www.co.kittitas.wa.us Kittitas County, Washington BOARD op COLINTY COMMIS SIONERS Fire Saf 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 at509-962-7000. 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? Yrl 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 servlng health/exempt from permit requirements lrttp: / f www.co.ki tti tas.wa.us/ 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 perrnit from KCPHD? If yes, please e a list of foods and beverages that you prepared the permi served at the event along with the name and tted 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 COURTIIOUSE . 205 WEST 5,I. , SUITE IOS ELLENSBURG, wA 98926 (s09) 962-7s08 FAX (509) 962-7679 wwrv.co. kittitas.wa. us at the event food.asp? intend on having phone number(s) of Are there permanent or fixed bathroom facilities already available at the location of the event? (s No 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 COURTI.IOUSE . 205 WEST 5.h , SUITE I08 ELLENSBURG, WA 98926 (s09)962-7s08 FAX (s09) 962-767e www.co.kittitas.wa.us Kittitas County, Washington BOARD oe COI-INTY COMMISSIONERS rt Law Enfo{cemenysecurity/Emergency Medical Services Will there be security on site during the event? Yes 116 If yes, please provide a complete list of nalnes 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? V" 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 confrol? V" No If yes, please provide documentation on how the traffic control will be addressed. Will there be off-site parking? Yes V If yes, please provide the location and a parking plan. Will there be shuttle buses provided for attendees? Yes If yes, provide a map of their route. Will there be alcohol served at the event? Yes lt6 v If yes, a State submitted wi permit is required from the WA State Liquor Control Board and must th your application materials. KITTITAS COUNTY COURTHOUSE . 205 WI]ST 5'h , SUITI] 108 ELLENSBURG, WA 98926 (s09) 962-7s08 FAX (509) 962-7679 www.co. kittitas.w:r. us Kittitas County, Washington BOARD on COTINTY 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 V 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 V6 KITTITAS COUNTY COURTHOUSE . 205 WEST 5,I" SUITE I08 ELLENSBURG, WA 98926 (s09)962-7s08 FAX (509) 962-767s www.co.kittitas.wa.us Kittitas County, Washington BOARD oF COLTNTY COMMIS SIONERS Garbage -ecycling Do you have a plan for garbage and recycling? Vt 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 509-9 62-7542. Insurance Have you obtained a Certificate of Insurance and endorsements, specifically naming "Kittitas Count5l" as an insured? VE 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 $2,000,000.00 aggregate coverage. This insurance must apply firbt and on a primary non-contributi"n"g b5sis in relation to any other insurance or self-insurance available to Kittitas County. Penal Bond - Bond of Indemnitv 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 $5,000.00 Penal Bond - Bond of Indemnity with your EventApplication? -Yes )i6 If no, you must request a letter in writing to the Board of County Commissioners requesting a waiver to the Penal Bond - Bond of Indemnity and outline the specific reasons why it should not be required of your event. CaunW Filings and Registration Is there a cost to attend the event? V" No How much are you charging to attend your event? 10.00 (optional) KITTITAS COUNTY COURTI.IOUSE ' 205 WEST 5.N , SUITE I08 ELLENSI}URG. WA 98926 (s09)962-',7s08 FAX (509) 962-767e wrvrv.c<l.kittitas.wa. us r.)o-33OJN.D(}AxethrowingPlay areaGift shopPicnicshelter!3E4='oOJdr)5HorseshoesS.orncholeRubber duckracesSilo cafeParking areaStorageshedStoragesiloBBQshackTo the animals(}Potties{-Hayride pick up anddrop offITrike courseGEAB Kittitas County Office Of The Treasurer Aruy Cziske, Trtasuttr 1O5 1[I Sih.Srrlur, i$ulir IUI Fjtensftqg,1ry* 98926 Phnno (509)962-7535 Fex(509) 933-8212 Cash Receipts Receipt Number: Received From: CheckAmount: CashAmount: OtherAmount: Total Amount: Deputy: SMYRA FundCode 001 2021-4942 Taylor Crouch GlCode t632l7l Date:08/23/2021 Template: Comments: Special Event Application Fee from Hilary Jensen- Head Gourd Girl $200.00 $0.00 $0.00 $200.00 Receipt Type: CHK Description SPECIAL EVENTS FEE Total Amount: Kittitas County Treasurer's Office Submitted By: SAVANNA MYRA Amount $200.00 $200.00 (c) 2OO2 Cashtax All Rights Reserved OB 123 I 2021 1 3:21 :24 S MYRA