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Application Agency <br /> <br /> PROJECT INFORMATION SHEET <br /> <br />(with which contract is to be executed) <br /> <br />2 <br /> <br /> Legal Name Street - City - Zip Phone <br /> <br /> Elk River Police Dept. 13065 Orono Pkwy, <br /> Elk River, MN 55330 (612)441-2324 <br /> <br />2. Authorized Official <br />Legal Name Street - City - Zip Phone <br />Chief Tom Zerwas Same as Above ( ) Same as Above <br /> <br />3. Operating Agency (if different from #1) <br /> <br /> Legal Name Street - City - Zip Phone <br /> <br /> ( ) <br /> <br />4. Contact Person for further information on application <br /> <br /> I <br /> I <br />Chief Tom Zerwas I Same as Above I( )Same as Above <br /> <br />I certify that the information contained herein is true and accurate to the best of my knowledge and that I submit this <br />application on behalf of the applicant agency. <br /> <br />Title: <br /> <br />Signature of Authorized Official: <br /> <br /> <br />