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SOS! <br /> 2�'70_ � <br /> Conservation Treatment Awards � <br /> �pp�icatic�n <br /> � Applicant is the owner of che sculpture. <br /> = Applicant is noc�he owner of the sculpture. <br /> TicleofSculpcure Commodore Stephen Decatur <br /> Owner of Sculpcure �Tty of �Decatur, Illinois <br /> Applicanc Organizacion Same <br /> Address 4�1 Gary K. Anderson Plaza <br /> Ciry/Scace/Zip Decatur, IL 62523 i <br /> Primary Concact Person Dane Bragg, Planner <br /> Telephone/z-rY/TDD �217) 424-2781 <br /> Fax (217) 424-2728 ' <br /> E-mail ' <br /> Approxima�e Projecc Dates: From/To <br /> 11/1/2000 — 11/1/200}. � <br /> Amounc Requested $ '7,550 <br /> Tocal Project Costs $ 15,100 � <br /> � <br /> I certify chat che information contained in this application,including all attachments and supponing I <br /> macerials, is crue and correct co che besc of my knowledge. <br /> Authorizing O�cial's Signature ; <br /> Telephone �21�) 424-2801 <br /> Are you delinquenc on repaymenc of any federal debc? No X Yes <br /> , <br /> � <br /> 17 <br />