Laserfiche WebLink
All Applications Must <br />Be Postmarked by <br />OCT 18 1977 <br />To Be Accepted for <br />Processing <br />APPLICATION FORM FOR THE <br />LOCAL GOVERNMENT COMPREHENSIVE PLANNING <br />ASSISTANCE PROGRAM <br />TO 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) :� <br />-6S-Z i a� f7J <br />ADDRESS: TELEPHONE: <br />11111111-4/yam//l�/ <br />CHIEF ELECTED OFFICIAL: TELEPHONE: <br />P Al <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 />Signatuof the Chief <br />Elec ed Official <br />/ 7-77 <br />Date <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 j?y each governmental <br />unit that is included in a 'off int application. <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 />ame of Entity <br />0 CT 5 1977 <br />• 7 <br />Harry Adley (813) 366-2420 <br />Contact person and phone number <br />1620 Main Street, Sarasota, Fla. 33577 <br />i <br />e <br />t <br />Aa�lt 3 F�Jr' <br />