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<br />ST A TE AND LAWCON <br />GRANT APPlICATION <br />TO ACQUIRE AND/OR IEYElOP lAND rOR PARK AND OPEN SPACE USE <br /> <br />WHERE TO SUBMIT. <br /> <br />Send two origin.l aigned cop!.. with Project Docu.ent.tion tOI Outdoor Recreation Grant. Section, Depart.ent 0' <br />Tr.' and Econo.ic Develo~t, 900 A.erican Center Building, 150 East Kellogg Boulevard, St. Paul, Minnesot. 55101. <br /> <br />A. <br /> <br />"'IT Of' GOVEIUKNT RESPCJISIIU rOR PRO.xeT. (.;flY a-- (. ~~ \/I k# ~ . <br />B. PRIMARY CONTACT PERSON rOR THE PRO.xCT. CtJAI~. <br />N.e ~~ ~ Title ~~.{#~ C~~n~ <br />Addre8.211~ Hltk 1Z-I::>~ I 0~1~.. HN Zip ..FJCO~ <br />#I~ I Phone. HOlle <4u 4-l~v, -e:l1..J(JtPrk <rt:lJ. ~"'-'k:512 . <br />NAME or PROXCTa ~~ ~V- <br /> <br />County <br /> <br />C. <br /> <br />former Project Number (if any) <br /> <br />,,--.. <br /> <br />D. TYPE or APPLICATION. <br />tl AcqulaiUon ~ Deve10pllent <br />E. PROJECT DOCUMENTATION - /::rer to check1iet) <br />The docu.ent. aubmitted in support of this application shall be considered part of this application. ' <br />r. rEII:RAI. EMPlOYER III:NTIFICATION NlJ4BER. -A:( ~ J&10W <br />G. EXECUTION a <br /> <br />t:l Combined Acquisition and Development <br /> <br />IN WITNESS THEREOF, the applicant has cau8ed this application to be executed on <br />19'&. <br />L~~flJ.e ,;It~d!n~ <br /> <br />By ~ r2!.. rY1a OO~ <br />Signature <br />"trt~Ch.irp.reon <br /> <br />r 0 R 0 r F ICE USE 0 N l Y <br /> <br />H. ESTIMATED PROZeT COST. <br />Section]La lAWCON/STATE GRANTS <br />A i iti <br /> <br />Development <br /> <br />s <br />s , <br />s <br />s <br /> <br />Combined Total <br /> <br /> cQu S on <br />Totel Coat S <br />r.deral Share S <br />St.te Share S <br />locel Share S <br /> <br />S <br />$ <br />S <br />S <br /> <br />Section!!1 ~ GRANTS <br />'A i iti <br /> <br />Development <br /> <br />Combined Total <br /> <br /> CQU s on <br />Tot.! Coat S <br />Stete Shere S <br />local Share S <br /> <br />$ <br />$ <br />S <br /> <br />s <br />s <br />s <br /> <br />CERTIfICATION BY THE OCPARTMENT or TRAil: AND ECONIJfIC IEVElOPHENT, OUTDOOR RECREATION GRANTS SECTION. The undersigned <br />~ hereby certifies that this project has a high priority rating according to criteria and priorities established in the <br />Minneeota Outdoor Recreation Plan or otherwiee meets the provisions of Ch. 11)9 and Ch. 179, Hinn. laws 1969. <br /> <br />w. are recommend I grant af S <br /> <br />08te <br /> <br />Deputy ~om.18.1an.r <br />Division of COMmunity Develop.ant <br /> <br />LAwtON APP/19-1 <br /> <br />Code 10 <br />Z aJPfE!? <br />