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DISASTER ASSISTANCE APPLICATION DEM - 131 <br />Application Identifiers State Number: <br />Federal i)lsaster Number: 424'a -DR -WA <br />f=ederal Catalog Number: 97.036 Title: Public Assistance Grants <br />Deellwat4on Dab+Janumy 15, 2016 <br />Appliearnf's #=EililA Project 1pp9cation Number; <br />Legal Applicant Recipient: <br />Applicant's Name: KITTITAS COUNTY <br />Street Address: 205 WEST 5TH, STE 105 <br />Mailing Address. 205 WEST 5TH, STE 105 <br />County: KITTITAS COUNTY <br />City: ELLENSBURG State: WA <br />Zip Code: 98926 <br />Applicant Agent: <br />Contact Information: <br />Name: MARK COOK <br />Phone: 5094SM-162--?52-2) e <br />Title: DIRECTOR PUBLIC WORKS <br />Fax: 509-962-7663 <br />E-mail: mark.cook@co.k1%tas.wa.u; <br />74�%+'�'`�'!Signature: 4ze___ <br />Date: March %,, ZM <br />Alternate Applicant Agent: <br />Name: KATHY.lURGENS <br />Phone: 6%' _`41r141,74096' <br />Title: PW FINANCE SYSTEM MANAGER <br />Fax: 509-962-7663 <br />E-mail; kathy_jurgens@co.kittitas.w2 <br />Signature: Irk <br />Date: March 1, 2016 <br />Type of Applicant: <br />A - State F - Higher Educational Institution <br />B - County G - Indian Tribe <br />C - City H - Private NonProfit <br />D - School District I - Other {Specify} <br />E - Special Purpose District <br />Enter Appropriate Letter <br />B <br />Congressional District Number: 8TH <br />State Legislative District Number: 13TH <br />cmrjzed <br />NOTE: Shaded blocks for WA EMD use. <br />