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<br />'. <br /> <br />.. <br />"~ <br /> <br />GRANT APPUCATlON . PART 1 <br /> <br />f"E!; :,.~~-- <br /> <br />AGENCYNAME TowN of L..A SnLLt. <br />PROJECT SUPERVISOMITLE N Co to SON R E /Ii 0 u. F <br /> <br />f'u,a...lc. WCI'KS DiR€C.-roft <br /> <br />ADDRESSJZIP CODE <br /> <br />f o. B,-~)f. 7/-1 <br /> <br />/,9 MAIN S", <br /> <br />i...A SAl.l..E: (:0...0. <br /> <br />"306+5' <br /> <br />PHONE: <br /> <br />(303) 2.S+-G~3i <br /> <br />FEDERAL 1.0. NUMBER g..,.. 6 0 00 (; 0 4- <br />TITLE OF PROJECT WA-re." COl-iSiRVA-r,ON r<'f'- PI..i.Bi..tC opeN >f'AcE: <br /> <br />AREA OF PROJECT IMPACT (Name of cities, counties, etc.) <br />LA S"LL';' WELD CO'-'-N-ry <br /> <br />Applicants are subject to the following conditions: <br /> <br />The grant recipient agrees to develop and adhere to a schedule for State review of the <br />project to assure that the scope and intent of the project results are achieved. <br /> <br />Applications requesting funds expressly for administrative purposes will not be <br />accepted. <br /> <br />THE APPLICANT CERTIFIES THAT. To the best of my knowledge and belief, <br />information in this application is true and correct. The document has been duly <br />authorized by the governing body of the applicanfs agency. I have read the above <br />conditions as well as the grant guidelines. <br /> <br />N~1..50N RI!.NOU.F Pt.lf3<...IC: \,v'o;tt<S DI/<.e.cToR <br />TYPED NAME AND TITLE <br /> <br />/ <br />~ // ,;;-.--; ,,/ <br />/-?J"4',..,....... /~.L--~.....:___. <br />SIGNATURE <br /> <br />/-30-"':2- <br />DATE <br /> <br /> <br />IflII.f.,llllfillil,!J&I'ltlalfl'111)IIIIllJli.r.l:lfl'ililI11IItl <br /> <br />-2- <br />