Laserfiche WebLink
BO1-4 <br /> PART H. APPLICANT CERTIFICATION <br /> THE APPLICANT CERTIFIES THAT: <br /> To the best of my knowledge and belief,data and other information in this application are true and <br /> correct, and this document has been authorized by the governing body of the applicant. <br /> CERTIFYING REPRESENTATIVE: <br /> (To be signed by the Chief Elected Official or Designee) <br /> Designating Onit of Government Ch' Elected Official or Designee <br /> -�o a Ma <br /> Date Title <br /> CERTIFYING REPRESENTATIVE: <br /> (To be signed by the Chief Elected Official or Designee) <br /> ( J Low b C <br /> Designating nit of GovernmeatJ qhliefffi ted Official or Designee <br /> N. <br /> 3- }o- e <br /> Date �� �Q <br /> Titl <br /> CERTIFYING REPRESENTATIVE: <br /> (To be signed by the Chief Elected Official or Designee) <br /> O o� De rc <br /> Design g Unit of Government Chi lected Official or Designee <br /> 3-)b-d 3 Moat 6 <br /> Date Title <br />