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V, <br />ANC- PRCW-_M <br />_U­_sement ?ec zest <br />1. Project `lar..e : <br />2. _rojec_ S_onsor: <br />?al io: <br />5. Rec'uest ?e__cd Covered: <br />E. <br />Cost --- ohlica__cns Total Cblications <br />Catecories Since '_.ast Re^.iest to mate <br />a. ccnt:act::al Seriicee, <br />nearing and/or : esiTjl <br />2) Const='sction <br />b. ?arc: ase -1 '.!aterial <br />c. Toza'_s <br />i <br />d. ?.rtc,Lnt of State _ ..^.ds Pequestec <br />(1/3 or 2/3 0: _tens 6C; <br />,:IR - ^:TAY <br />i . ._st3r"'r crm'at ?.e^_1as t ictal stat'_' s'r.ax°_ :Coal Share <br />5 i <br />b. C'.:.-aulativp total:, <br />to date 5 $ <br />a. Total ands A=nroved -_- = a,_2 Grant <br />IL b. Total state :''_nds .aid Czl%..:r. ib (2) ' I <br />C. Halarce of State Gant 5 <br />9. ccr__licat_:on: <br />Z certify/ _*-at _.._s request is _orrec_ and .. and is --ased Lon <br />act_,al ..Cl-?at_cns of __cord by the .ro,•'C_ _ccnscr; =nat ..._3 est and <br />acC=..enzaL_Jn 15 reccr:!ec in 7,-e ?ro4ect __cnzcr' :; _ubl__ re-or!s. <br />t :ac =ay.me.^.t =_ora stat`_' (Las not Veen recei red; _: <br />at _: d �O_.. =^C 3...rY:_:s <br />are in accordance '"ith the .'1er_da Department a- <br />or-.4ect acree^ent includina an,; ame.^.d=eats t :er`3to; and that : rog_ess O: the <br />,,mzk and ser -.rices _,nd _ _ne ?ro; 'Ct ac nement are 5at_s-ac-Orf and ar9 :On 3_5- <br />tent with _ne ar..cunt _equest2d. <br />D=r--t-- <br />:_4vj z'_cr. of ' ecr_..t_cn and tar:<s <br />Or ut'Or_=ec tie?resant?_t:._ <br />ate <br />Dat_ <br />.ate <br />Mav 14, 1982 <br />Page 7 of <br />