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s. <br />W <br />All Applications Must <br />Be Postmarked LZ <br />To Be Accepted for <br />Processing <br />APPLICATION FORM FOR THE <br />LOCAL GOVERNMENT COMPREHENSIVE PLANNING <br />ASSISTANCE PROGRAM <br />W BE SUBMITTED TO: Mr. John Sidor, Jr., Director <br />Division of Technical Assistance <br />Florida Department of Community Affairs <br />2571 Executive Center Circle, East <br />Tallahassee, Florida 32301 <br />APPLICANT (city, county) : City of Sebastian <br />ADDRESS: TELEPHONE: <br />City of Sebastian <br />P. O. Box 127 (305) 589-53307589-4303 <br />Sebastian, F1 32958 <br />=HIEF ELECTED OFFICIAL: TELEPHONE: <br />Mayor F. Eugene Cragg (305) 589-4303 <br />The Applicant certifies that to the best of his knowledge and belief, the data <br />in this preapplication are true and correct, and the filing of the preapplica- <br />tion has been duly authorized by the governing body of the Applicant as con- <br />firmed by an attached resolution. <br />October 10,1977 <br />Signature of the Chiet Date <br />Elected Official <br />NOTE: Application must be signed by the chief elected official and include all <br />identifying information, fiscal need information, and a resolution from the <br />governing body. A separate application must be submitted by each goverrumental <br />unit that is included in a '03 int application. 1 <br />FOR JOINT APPLICANTS ONLY: Please indicate below the designated common plan- <br />ning entity which will be responsible for the work to be performed: <br />Name of Entity <br />RUSSELL & AXON <br />09 <br />OCT 197 <br />Contact person and phone numbor <br />Mr. James T. Steffens AIP <br />Russell & Axon <br />1620 Mason Ave., Dautona Btlach, Fla.32011• <br />TEL.: 9041255-5471 <br />MU -L PAGE 4J3 <br />I <br />