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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 /> <br />SECTION II - APPLICANT INFORMATION <br />SUBGRANTEE INFORMATION <br /> <br />SUBGRANTEE: >ICASS COUNTY! <br />FIPS CODE: >I!!I <br />COUNTY: >lcAsS/ <br />TYPE: GOVERNMENT ~ INDIAN TRIBE 0 PRIVATE NON-PROFIT 0 OTHER [:=J <br /> <br />CONTACT: <br /> <br />NAME: <br /> <br />>loAVE ROGNESsl <br />>1 EMERGENCY MANAGERj <br />>jCASS FARGO EMERGENCY MANAGEMENlj <br />>~630 15 AVENUE NORTHI <br />>IF ARGO! <br />>~ ZIP CODE: >158102-58011 <br /> <br />TITLE: <br /> <br />ORGANIZATION: <br /> <br />ADDRESS: <br /> <br />CITY: <br /> <br />STATE: <br /> <br />DIRECTIONS: <br /> <br />>c=J <br />>c=J <br />>c=J <br /> <br />NOT APPLICABLE AT THIS TIME <br /> <br />CARRIER CODE: <br /> <br />USPS BAR CODE: <br /> <br />NOT APPLICABLE AT THIS TIME <br /> <br />LOCATION CODE (if any) > c=J <br /> <br />NOT APPLICABLE AT THIS TIME <br /> <br />LONGITUDE: <br /> <br />>c=J <br />>c=J <br /> <br />LATITUDE: <br /> <br />E-MAIL ADDRESS: <br /> <br />>1701-476-40651 FAX NO: <br />>jROGNESSO@CO.CASS.NO.usl <br /> <br />>~01-476-402~ <br /> <br />TELEPHONE: <br /> <br />NFIP PARTICIPATION [SJ YES <br /> <br />DNO <br /> <br />LAST CAY DATE: C=:J <br /> <br />APPOINTMENT OF APPLICANT'S AGENTATTACH/ENCLOSESIGNED DESIGNATION OF APPLICANT AGENT <br />FORM (FORM IS AVAILABLE THROUGH THE STATE) <br /> <br />3 <br />