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Applicant Certification <br />Certification is hereby given ~ the informatio~ provided is accurate and the appli~ble attachments 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 />Signature of Agency Representative <br />Typed or Printed Name <br />Sponsoring Agency <br />(If Applicable) <br />7 /tS-/olDI 'f <br />Date <br />Date <br />Date <br />Associate Economic Development Organization Notification <br />The organization listed below has received notiftcation or this application as demonstrated by the <br />signature oftbe organi7.ation's representative. <br />Name of Organization <br />Signa ~ l)f;l> -r/J.S@-01'1 <br />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