b. Hazard mitigation awareness grant

INSTRUCTIONS: a. Press F1 for help for each field. b. Navigate through the form by using the TAB key or the mouse to highlight and enter data in each field. c. All Questions in RED are required. d. Documents attached must be in version WORD 97 or above or WORDPERFECT 6.0 or above. (R8-PA-5/1/2004) -------------------------------------------------------------------------------------------- -------------------------------------------------------------------------------------------- Name, Address, Phone, FAX number, etc., of the Local Floodplain Administrator/Manager: NAME: TITLE: ORGANIZATION: ADDRESS: CITY: DIRECTIONS: CARRIER CODE: USPS BAR CODE: >IMIKE ZIMNEyJ >ICOUNTY PLANNERI >ICASS COUNTy! >11201 MAIN AVE. WESTj >!WEST FARGOISTATE: >c::J >C:J >c::J >lHQ] ZIP CODE: >1580781 LOCATION CODE (if any): >C:J LONGITUDE: TELEPHONE: FAX NO: E-MAIL ADDRESS: >c::J LATITUDE: >c::J >1701-298-23751 >1701-29823951 >IZIMNEYM@CO.CASS.ND.USI Name, Address, Phone, FAX number, etc., of the State CAP Coordinator: NAME: TITLE: ORGANIZATION: ADDRESS: CITY: DIRECTIONS: CARRIER CODE: USPS BAR CODE: >C:J >C:J >c::J >c::J >c::JSTATE: >c::J >C:J >c::J >CJ ZIP CODE: >C:J LOCATION CODE (if any): >C:J LONGITUDE: TELEPHONE: >c::J >C:J >C:J LATITUDE: 32