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<br />Oregon Depa~tinent of Environmeata/,Qua/ity . • ,~ _ . Paqe 5 of 5~
<br />Sfate Revo/ving Fund,P~ogram . , - ~ .
<br />, Fina/ App/ication .
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<br />.' 19. Auttiorization:. ; • . - :
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<br />THE PUBLIC AGENCY/APPUCANT CERTIFlES_THAT the Applicant will ~use State .~
<br />,~. Revoiving Fund loan proceeds only for the project desc~ibed in, this application.
<br />: It will comply with all.applicable rules and laws. The Public Agency will obtain ; ,
<br />all applic.able local, state; and federal permits, approvals, and licenses; and
<br />comply w~th thei~ terms and cone'Public Ah e c~e -~' ~9ned is duly authorized to ;
<br />:. reguest this 'loan on behalf of th g y he: Public Agency declares
<br />'. under penalty of ~law th,at all fact,s given and information attached a~e fi'ue and ~
<br />. : ~correct: The Public Agency,autfiorizes DEQ to ve~ ify all infor`mation. _
<br />. „ ~ - . / . . ~ ' ~ ~ : ~ ,~-'//~~`~ F,~,.• ':f ~ ,` .. , , ~. ~ .. ~ J; ,_ll.~ ~ ~ .
<br />. ~ ' • . ~ ~ '~ G.l; yf.~ ~ .
<br />. ~ Authorized Signature::/`~~~ ' ~/J 4 •_ Date:_ -.
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<br />~ Typed' Name arid Tit1e: TIi D Gleason Citv '~1ana er ' ,. "
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<br />20. Return the completed application to yo.ur DEQ Project Officer-' ,:: ` °, ' h
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<br />~ -` EASTERN REGION: DON GALDWELL. (503).276-4063 ~ ,
<br />. _ ~ 700 S.W. Emig~ant, Suite 330 - ~ ~ ~ .
<br />• ~. Pendleton; O~egon 97801 - .~
<br />NORTHWEST REGI:ON: RICHARO SANTNER (503) 229-5219 ~
<br />` ` ' 2020 S.W. 4th Avenue,.Suite 400 ~
<br />- . • Portland; O~egon 97201~-5884 .
<br />- • ~'~' WESTERN REGION: . . ; JOSEPH EDNEY. ~ ~ (503) 686-7838, ext. 237
<br />~ . ~ ~ ~ JAIME ISAZA , (503) 686-783$, ext. 233 ~ =
<br />, ` . , ~ , • - -~ , ' 1102 Lincoln Street, Suite 210 , , :
<br />- ~ . Eugene, O~egon, -97401 ' , ~ :
<br />' . ~ . DAVE CHESMORE ' (503) 776-6010,; ext. 239 ~ ~ ~
<br />. - , 201 W. Main Street, Suite 2-D ~ - ~.
<br />' " ~ ~ Medford,' Orego~;'97501 ` ' ,
<br />./If you do not know the name of you~ DEQ SRF Project Officer, o~ have other
<br />:~ - ~, questio~s rega~ding the°State Revolving Fund program; please call: ± i
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<br />~ ' PEGGY HALFERTY ,(503) 229-6412 . ~ -
<br />' ~ - ~ MAG.GIE VANOEHEY (503,) 229-6878 -. ~ ' ~
<br />. . - ' MARTIN LORING .- (503) 229-5415 ~ _
<br />, FAX: (503) 229-6037 _ _ . .
<br />~ . - , State Revolving Fund (SRF) Rrogram ~
<br />, ~ Water Quality Oivisio~ " , . ~
<br />~ , Orego~ Oepartment of Enviro~me~tal Quality . ,
<br />' ~ 811 S.W: Sixth Avenue , _ , ,
<br />~ ~ .. . Portland, Oregon 97204=1390 , . ~ ~ . _ ~..
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