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Applicant Certification <br />Certification is hereby given that the information provided is accurate and the applicable attachments are <br />complete and included as part of the applicdion package. <br />I that1' dmesholds am met at ft time of application. <br />afore of ciai Representative Dame <br />Sponsoring Agency <br />(If Applicable) <br />bigoatnre of Agency Representative <br />Typed or Printed Name <br />Date <br />Date <br />Associate Economic Development organization Notification <br />The organization tilted below has received notification of this application as demonstrated by the <br />signature of the organization's representative. <br />Kittitas Caimty Chamber of Comma= <br />Ila; <br />israHon. <br />7 11W <br />ignature okk4iwentatie Date <br />Kittitas County Department of Public Works Receipt of Application <br />Signature of Kittitas County DPW Representative Date <br />Typed or Printed Name <br />10 <br />