Laserfiche WebLink
<br />719-336-8989 <br /> <br />p..:! <br /> <br />Jul 12 ~~ 11:33a <br />.07/07/99 12:54 <br /> <br />'Zt303 866 44 74 <br /> <br />Environmental Health S.E. <br /> <br />@oos <br /> <br />. <br /> <br />. <br /> <br />. <br /> <br />CWCB <br /> <br />APPOINTMENT OF APPLICANT'S AGENT <br /> <br />FEMA-DR.1186-CO. <br /> <br /> <br />--- <br />W1 ",'-'I V I D,r,-.:S <br />(Nome of AppliCII/Jt's Agenl) <br />.LQ,[;) Co S D. 'I ci .'ST; <br />(Busme55 Add,...) <br /> <br />/... A-n'IIrR.. (' .D <br />(City, State, Zip Code) <br /> <br />'S/vs:;;.. <br /> <br />~~. PLIl'/ll ;!-d.t'YI,n, <br />(Tide) <br /> <br />Businc.. Ph""e: 1/ q - .3 3f&, - 'i?'Ti1K <br /> <br />Home PboDt: <br /> <br />'719'''' [" if'?' - c3 OD J.. &e.Ll..-J <br /> <br />FAXNumher: 'Ilr -33[" -'3'rffr <br /> <br />'fr1/l" ...;~y ----;----;, (" .. ~~ S I. hereby aurhorized to execute for lIIId on beh.lf <br />(Applic3Dt's een!) <br />of P,,-I'>'" et"S (7 n u ." jI , I public entity established under lh.lsws oflbe <br />(Applicant or Sub-Orante.) / <br />State of Colorado, Ibis applicallolllllld 10 file it with the Depanmenl of Local Affairs, Office of EmergOZlcy <br />ManaaemODt for the ~ of obtoining FodeCllI flllOncial "'\sIllllCe Illlder tlte Di..ster relief lcl (Puhlic <br />Law 93.lU u emeDde<1), or otherwi.e ~vai1ablc fromlhe President' & Disasle< relief fuild. <br /> <br />Thatrhe -P"n,,,.e.rs tJ ~fL..~G.,,/ . ,.publieCtltityestablishcdUDdc:rThcl.wsofthe <br />Slale of Colorado, her.by outhOl1ZCS i alCDI to provide to the StoIC IlIld to the F ~raJ ElIlorgellcy <br />Manage:mCllt AS"DCY for .llm'llers pel1ainillg '0 sucb federal disa.sler assistance rhe wurallces"""ched <br />10 the project applicstion. <br /> <br />1-7-9'( <br />(Date) <br /> <br />Approved By: <br /> <br />"rrJ.'J"Il/1I11 $:5 /" pee; <br /> <br />(C ierElected Offiei.VDireetorlM egerlPresident) <br />(Type Name IIld Title) <br /> <br />eu V y.~<J.- <br /> <br />(SignatUre) <br /> <br />