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' <br />Applleant Certllea«on <br />Certification i.a hen:by given that 1he infor,nauon provided is accurate and 1he applicable attachments are <br />complete and included as pert of the application paclcage. <br />I certify that application tluabolda are met at the time of applicadon. <br />~~~~ <br />Slpatan of Aaency ReprtNQtative <br />Typed or Printed Name <br />SpoalOl'hlg AgCDC)' <br />(If Applicable) <br />Date <br />Date <br />Date <br />Aaodate Eeoullllc Dmllopment Orpldratlon NotUlcadoa <br />The orpniatlon li1ted below ha, na,ived notilleatlon of tbls applleadon u danomtrated by the <br />1lgnature of 111, orpnlz:adon'1 repNHldadve. <br />Date <br />Kltttta• COlllltf Depart•e,at of Public Work, Receipt of Applleadaa <br />Slpature of Kittltu Couty DPW Repraeatadve Date <br />Typed or Printed Name <br />10