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Applicant Certification <br />Certification is hereby given that the informadon provided is wcurate and the applicable wachnients are <br />complete and included as part of the application package. <br />I certify that application thresholds are met at the time of application. <br />R <br />CM <br />Sign re of Officid Representative <br />Sponging Agency <br />(If Applicable) <br />Signature of Agency Representative <br />Typed or Printed Name <br />-rlks-kavity <br />Date <br />Date <br />Date <br />Associate Economic Development Organization Notitcation <br />The organization listed below has received notification of this application as demonstrated by the <br />signature of the organization's representative. <br />.....�.r <br />-r /Saw <br />Date <br />Kittitas County Department of Public works Receipt of Application <br />Signature of Kittitas County DPW Representative <br />Typed or Printed Name <br />Date <br />10 <br />