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10/24/05 MON 13:45 FA% 541 P , 4882 EtTGENE P~ IIiNTNC & P``~~; P~ ADMIN X002. <br /> APPLICATION F017 oMe approval Na, o3as-oo43 <br /> FEDERAL ASSISTANCE z. DATE SUBMITTED Applicant Id®ntifler <br /> t- 03 <br /> • TYPE OF SUSM133ION; 3. DATE RECEIVED 13Y STATE Stale Application (dentllier <br /> ficat"ron Preappticatlon <br /> ~Conetruction ? Construction a_ DATE RECEIVED BY FEDERAL AGENCY Federal Identifier <br /> gn.Qopstryction Non-Construction <br /> 5. APPLICANT INFORMATION <br /> Legal Name: O ¢atlanal Unit: <br /> A•r <br /> G. <br /> Cre:~ o t D <br /> ,~bt <br /> t <br /> <br /> • C: o <br /> 'n <br /> Address (give dq% oounry.•Stata, nd 2ip code): Name antl tel®phone rnrml~r o! person to be tatted on matters invotvi <br /> i <br /> i raa~COde d'ot' <br /> this appl'xatlon (g vs a ) ~w(~ <br /> ~ Y <br /> s5 B <br /> E~ any oiZ. ~ ~Jo( S`~() ~ q a - 5~ <br /> TIFICATION NUMBER (61N]: 7. TYPE OF APPLICANT: (enter approp~tate le(tgrfn box) <br /> PLa ERIDEN <br /> 6. EM <br /> A State H. Irx~ependent School Dist. <br /> t3. TYPE OF APRLlCAT10N: !3. County I. State Controlled Institution of Hlghar Learning <br /> I''? New ~ Confinualion ~ Revision C. Municipal J. Private University <br /> D_ Tawnshlp K Indian Tube <br /> ter a ate lefter(s) inbox(es) E, lnEe~slate L. Individual <br /> tf Revisl~, en pproprl <br /> u ? anaauon <br /> F. Intermuniapal M. Profit Org <br /> A. Increase Award B. Decrease Award C- Ind'ease Duration G. 5peaal DlsMct N. Other (Spedlyj <br /> D. Decrease Duration Other(sPac+fY1= <br /> 9. NAME OF FEDERAL AGENCY: <br /> GI•S. .b,,~(,LGtw p~ l~A~• t <br /> id. CATALOG OF FEDERAL DOMESTIC ASSISTANCE NUMBER: 11. DESCRIPTNE'iYT'LE OF APPLICANT'S PROJECT- <br /> ~ - D K Ass: <br /> s~~?~c r4~ru-,~,~,~- <br /> TtTLE: W~l f~i~e- Mang ~+.Y.-k' f~t9-Ao3/ lvtt~a W~~ E~i,~ <br /> 12 AREAS AFFEt,-Tf=D BY PROJEC't'(C/tfes, Coon s, Stalest etc.): ~ /S `Q~ <br /> ~ ~tan~ L.p r~'~•f, o r IW10~ <br /> 13. PROPOSED PROJECT' 14. CONGRESSIONAL D15TRICTS OF: <br /> Start Date Ending Date a. Applcant b. Project <br /> b- -o q 3e-o 4' Faµri~t... ~ Fe t~.f-1'L. <br /> 15. ESTIMATED F LADING: may-- 16. fS APPLICATION SUB.IECT TO REVIEW BY STATE EXECUTIVE <br /> ~,t ( (pts Q (d•G~ ORDER 12372 PROCESS? <br /> a. Federal $ <br /> a. YES. TH15 PREAPPLICATIOWAPPLICATtON WAS MADE <br /> b. Applicant S AVAILABLE TO THE" STATE EXECUTIVE ORDER 12372 <br /> PROCESS FOR REVIEW ON: <br /> c. State $ <br /> DATE <br /> d. Local $ oa <br /> b. No. ~ PROGRAM IS NOT COVERED BY E. 0.12372 <br /> e Other $ ? OR PROGRAM HAS NOT BEEN SEl>wCTf=b BY STATE <br /> FOR REVIEW <br /> i. Program income $ ~ <br /> 17. IS THE APPLICANT DELINQUEN'T' ON ANY FEDF.IZgL pEBT? <br /> g. TOTAL. $ - Yes N "Yos," attach an axplanatlon. ~o • <br /> 1 B. To THE BEST' OF MY KNOWLEDGE AND BFJJEF, AI.L DATA IN THIS APPIJCAT'IONIPREAPPLICAT1oN ARE TRUE ANO CORRECT, THE <br /> poCUMENT HAS BEEN DULY AUTHORIZED BY THE GOVERNING BODY OF THf=APPLICANT AND THt=APPLICANT WILL COMPLY WITH THE <br /> ATTACHED At3SURANCES IF THE A53tsTANCE IS AWARDFA. <br /> a. Type Name of Authorized Raprssentatlve b. Title G T lep Number 5.33 .b <br /> D~~.,cs /H.. T t'a< G: a Silt b <br /> ~Fj'C7 d. Sig re o! Authorized epresent~ytare~- ri. Date <br /> Z <br /> / PrAVio ition Usable ndatd Form 424 (Rev. y-97) <br /> orrzed !or Local Reproduetlon Prescribed by OMB Clreular A-102 <br /> <br />