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<br />FOR STATE USE ONLY <br />CONFORMS TO ITEM: <br />ON PAGE: <br />PRIORITY #: <br />PROJECT #: <br />DATE APPLICATION RECEIVED: <br /> <br />STATE PROJECT APPLICATION FORM <br /> <br />PART 1 - PROJECT INFORMATION <br /> <br />STATE: ND <br /> <br />DATE OF SUBMISSION: July 21,2004 <br />SUBGRANTEE INFORM A TION <br /> <br />SUBGRANTEE: Cass County Emeraency Manaaement <br /> <br />FIPS CODE: _(Provided by the State) <br /> <br />COUNTY: Cass <br /> <br />TYPE: [8JGOVERNMENT DINDIAN TRIBE DPRIVATE NON-PROFIT DOTHER <br />STATE LEGISLATIVE DISTRICT (SEE APPENDIX B): - CONGRESSIONAL DISTRICT: 1 <br /> <br />CONTACT NAME: Dave Roaness <br /> <br />TITLE: Emeraency Manaaement Coordinator <br /> <br />ORGANIZATION: Cass County <br /> <br />ADDRESS: 211 9th Sf. S, PO Box 488 <br /> <br />CITY: Farao <br /> <br />STATE:ND <br /> <br />ZIP CODE: 58107 <br /> <br />TELEPHONE: (701) 239-6790 FAX NO.: (701)- <br /> <br />E-MAIL: RoanessdCâ>.co.cass.nd.us <br /> <br />ALTERNATE CONTACT NAME: Tammy Karlaaard <br /> <br />TITLE: Graduate Assistant <br /> <br />ORGANIZATION: Emeraency Manaaement Proaram <br /> <br />ADDRESS: 3160 33rd St SW <br /> <br />CITY: Farao <br /> <br />STATE: ND <br /> <br />ZIP CODE: 58103 <br /> <br />TELEPHONE: (701) 239-7069 Cell NO.: (218) 205-1499 <br /> <br />E-MAIL: tammy. karlaaardCâ>.ndsu .nodak.edu <br /> <br />NOTE: ATTACH A COpy OF THE APPOINTMENT OF APPLICANT'S AGENT FORM (PERSON EMPOWERED TO ACT ON BEHALF OF THE <br />APPLICANT WITH REGARDS TO THIS GRANT AND PROJECT (IF PROJECT IS APPROVED)). SEE APPENDIX D FOR FORM. <br /> <br />PROJECT INFORMA TION <br /> <br />PROJECT TITLE: Statewide Loss Estimation from Hazards-ReDort Writina <br /> <br />PROJECT LOCATION (COUNTY-WIDE FOR COUNTY NAME): <br />State of North Dakota, all counties and incorDorated cities <br /> <br />5 <br />