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Applicant Certification <br />Certification is hereby given that the information provided is accurate and the applicable attachments are complete and <br />included as part of the application package <br />I fy that a b1c thresholds are met at the time of application <br />Si n ture of ffi ial Representative <br />Sponsoring Agency <br />U� <br />(if Applicable) <br />Signature of Agency Representative <br />HaAM br + Hays <br />Typed or Printo Name <br />� lg/l7 <br />Date <br />Datb I�7 <br />V11f10 <br />Date <br />Associate Economic Development Organization Notification <br />The organization listed below has received notification of this project as demonstrated by the signature of the <br />organization's representative. <br />Date <br />Kittitas County Department of Public Works Conceptual Approval <br />Approval of the project feasibility, scope and estimated costs. <br />Signature of Kittitas County DPW Representative <br />or Printed Name <br />Date <br />14 <br />