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411111111 <br />40 <br />OMB Approval No. 034^DM <br />.sgalNanw <br />Indian River County <br />Application for Federal <br />organtrarlanar Una --. <br />Board of County Commissioners <br />' Assistance <br />2. Data Su ad Applicant W111111i <br />1 Typo of Submission. <br />3. Dale RocoNed by Stall <br />State Application <br />Application Preappllcatlon <br />4. Dole Received byFaderdAWLy <br />FaderalkkMller <br />❑ Construction (] Construction <br />L � A <br />U Non -Construction © Non•Constructlon <br />A. State H. lnclapandent School Dist <br />-. .AL <br />B. County I. State Contolled Institution of Higher Laarning <br />OMB Approval No. 034^DM <br />.sgalNanw <br />Indian River County <br />- <br />organtrarlanar Una --. <br />Board of County Commissioners <br />lddress (give city, county. Slate, and 41P odds): <br />nahors <br />Name, telophona nurnoer. and lacetml* number of the person Io be eoruacled on <br />nvotving this applcallnn (give arra codes) <br />Louise Hubbard MPA <br />(561)231-5860 <br />FAX Number: 561-234-5298 <br />s. Ern ploys Ida ntiflattonNumber(Elft <br />7. Type of Applicant: (enter oppropriats letter In box) FLI <br />L � A <br />A. State H. lnclapandent School Dist <br />-. .AL <br />B. County I. State Contolled Institution of Higher Laarning <br />— — - <br />B. Type of Application: <br />C. Municipal J. Privata Lln"mity <br />0 Now O Continuation Q Revision <br />D, Township K. Indian Tribo <br />It Revision, enter appropriate Wier(s) In boot(es): <br />FJ <br />E. Interstate L. Individual <br />F. tntermunfi; M. Profit Organization <br />J <br />fl. Spodal Distrtcl N. Non-profit <br />Other (Specify): <br />A. Incroase Award B. Decrease Award C. Increase <br />Duraltion <br />g.NamaofFoderstAgorwy: <br />U.S. Dapartmentof Housingand Urban Development <br />D- decrease Duration Other (speeltft <br />10. Catalog a IF ads rat Damsel lc Assistance Number, <br />1 �_ <br />Title SLLppay`4112, 9W91117 <br />2)ptions <br />`` <br />11. Descriptive This of ApplI Cama Project: <br />Team --Supportive Services Only <br />ase Monitoring and Housing Specialist <br />d <br />iupportive Services Team to outreach <br />rko66a4M <br />and refer clients and find housing and <br />services. <br />12. Areae Affected by project (clues, counties, States, etc.): <br />Indian River Co. FL <br />la.prapoeeo project: <br />14.Congre*elonal ulemctaol. <br />a. Appticalll b. Ptosed <br />15 15 <br />18.1* Appllutlon Sub)ace to rtevlaw by State Execullve Order 12'472 Pmeaeey <br />a. Yes This pro applicaticrJapplication was made available to the <br />State Executive Order 12372 Process forraview on: <br />b. No Program is not covered by E.D. 12372 <br />or Program has not been selected by State for review, <br />17. bl thoA ppllcant nati nq uent en Any Fedarel Debt? <br />Yes 11 'Yes,' explain below or attach an explanahon <br />>U No <br />is To We st of my knowLed ge and W icf, A data in this application/preapplication are tme and correct, the doc Unient has been duly authorized <br />_ by (lie governing body of the applicant and the applicant will comply with the attached assurances if the assistance is awarded. <br />a.. Typed Name a Aulhollzed Reprosenlalive b. Tina c.Tolophena Numoaf <br />Fran B. Adams <br />d. <br />SIgnatutpokAuftrized Nspre „tel, e. atIZ��Q,IA May e 2{}00 <br />FfeYlous Editions Not U/able Page t of 2 forret SF -U4 (4A)2) <br />Prascribad by OMB Citcullt A•102 <br />