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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 />SECTION III - PROJECT INFORMATION <br /> <br />SUB GRANTEE APPLlCA TION PREPARER <br /> <br />CONTACT: NAME:DAVE ROGNESS TITLE:EMERGENCY MANAGER <br />ORGANIZATION: CASS FARGO EMERGENCY MANAGEMENT <br />ADDRESS: 463015 AVENUE NORTH <br />CITY: FARGO STATE: NO ZIP CODE:58102-5801 <br />DIRECTIONS: <br />CARRIER CODE: USPS BAR CODE: <br />LOCATION CODE (if any): <br />LONGITUDE: LATITUDE: <br />TELEPHONE: 701-476-4065 FAX NO: 701-476-4020 E-MAIL ADDRESS: <br />ROGNESSD@CO.CASS.ND.US <br />A copy of the document appointing as the Applicant's Agent, empowered to act on behalf of the applicant with <br />regards to this grant proposal and project (if the project is approved) is attached as <br /> <br />PROJECT TITLE: <br /> <br />>INORTH DAKOTA PREAPAREDI CALENDAR PROJECT1 <br /> <br />PROJECT LOCATION: <br /> <br />1. DETAILED LOCATION (include the leqal description, latitude and longitude coordinates): (Press F1 for <br />help) <br /> <br />I>N/A <br /> <br />2. Attach or enclose originalMaps (USGS, City plat maps, aerial photos) original and original diagrams <br />depict the exact project location. Maps should be oriented with a North arrow. <br /> <br />I>N/A I (Press F1 for help) <br />Is there restriction or permanent conservation easement on the property at the project site that would <br />(Was there a previously FEMA funded buy-out of a structure on this property?) <br /> <br />I>N/A <br /> <br />3. LIST ANY PUBLIC ASSISTANCE DISASTER SURVEY REPORTS (DSRs) or PROJECT <br />WORKSHEETS (PWs) THAT WERE COMPLETED AT THE PROJECT'S LOCATION FROM <br />PREVIOUS DISASTERS (ONLY WITHIN THE LAST 10 YEARS). <br /> <br />6 <br />