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' ' Illinois Main Street <br /> ����� <br /> ��j � Office of Lieutenant Governor Pat Quinn <br /> SECTION I: READINESS TO PARTICIPATE <br /> 1. Town: � ��'�,� <br /> 2. County: ��(�,�('d�,�1 <br /> 3. If there are questions about this application, who should be contacted? <br /> Name: 1 Y�l LP�(..PYI w�l�S ( X� �c_,t)/1 1�„ �('C27-C� ' a't Gf / <br /> Address: ��57� /U (..c�C��°.� S-�"���, S U/� � 7� <br /> ��'e�-{�--� ZL �n�S�?� <br /> Phone#: 0'�/7- �/o�� - �L/�7,`� �a.x# �l�7- �-/�� - .3ydl� <br /> E-mail Address: G�It�(�-1-vi' � <� �l 1�-�z'���i'��'l'cc -c'' -�� <br /> 4. Certification of Applicant <br /> The primary contact named above and one representative from municipal government should <br /> acknowledge the following statement: <br /> I hereby certify that the city of �C ac i and�L��fcv�i� <br /> I�eCcrfvi f:�.c.�r c�'/ (existing local organization if applicable) submit, approve, and <br /> endorse the submission of this application to the Illinois Main Street program and that the <br /> facts and data contained therein are true and accurate to the best of our knowledge. <br /> Acknowledged by: ���� ��`�l�- (Mayor) <br /> Printed Name of Mayor:�_(, �,c� h LY'i'J E' Date: �-%�D(.� <br /> Acknowledged by: (Primary Contact) <br /> Title (ifapplicable): �����r,c.c� l�i/eF-/t� Date: �p-7/'J(o <br /> Page 1 of 26 (Revised 4/06) <br />