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<br />INSTRUCTIONS: <br /> <br />a. Press F1 for help for each field. <br />b. Navigate through the form by using the TAB key or the mouse to highlight and enter data in each field. <br />c. All Questions in RED are required. <br />d. Documents attached must be in version WORD 97 or above or WORDPERFECT 6.0 or above. <br /> <br />(R8-PA-5/1/2004) <br /> <br />-------------------------------------------------------------------------------------------- <br />-------------------------------------------------------------------------------------------- <br /> <br />STATE PROJECT APPLICATION FORM <br /> <br />ORNO.:I <br /> <br />STATE: D <br /> <br />------------------------------------------------------------------ <br />------------------------------------------------------------------ <br /> <br />PROJECT NO.: <br /> <br />(Press F1 for help) <br /> <br /> <br />SECTION 1- STATE INFORMATION <br />GRANTEE INFORM A TION (IF APPLICABLE) <br /> <br />GRANTEE: >D <br />CO NT ACT: NAME: >c=J <br /> TITLE: >c=J <br /> ORGANIZATION: >CJ <br /> ADDRESS: >c=J <br /> CITY: >CJ <br /> STATE: >CJ <br /> DIRECTIONS: >c::=J <br /> CARRIER CODE: >c::=J <br /> USPS BAR CODE: >e:::J <br /> LOCATION CODE (if any): >e:::J <br /> LONGITUDE: >c::=J <br /> LATITUDE: >c::=J <br /> TELEPHONE: >e:::J <br /> E-MAIL ADDRESS: >e:::J <br /> <br />FIPS CODE: <br /> <br />>D <br /> <br />ZIP CODE: <br /> <br />>c=J <br /> <br />NOT APPLICABLE AT THIS TIME <br /> <br />NOT APPLICABLE AT THIS TIME <br /> <br />NOT APPLICABLE AT THIS TIME <br /> <br />FAX NO: <br /> <br />>e:::J <br /> <br />PROJECT CONFORMS TO ITEM > # c=J <br />in the State's Multihazard Mitigation Plan (if necessary also list which annex of the plan in the shaded text box.) <br /> <br />According to the State's Multihazard Mitigation Plan, PROJECT IS PRIORITY ># c=J. <br />OTHER PROJECT TYPE DESCRIPTION (describe here in 100 characters or less or attach word document): <br /> <br />STATE LEGISLATIVE DISTRICT: <br /> <br />>D <br /> <br />2 <br />