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? SIGNATURE AUTHORIZATION FORM <br /> FOR GRANT/LOAN RECIPIENTS <br /> fes, . -_ Department of Ecology <br /> Water Quality Program <br /> PO Box 47600 <br /> Olympia,WA 98504-7600 <br /> WASHINGTON STATEPhone: (360)407-6600 <br /> DEPARTMENT OF <br /> ECOLOGY FAX: (360)407-7151 <br /> Name of-Organization Date Submitted <br /> Project Title Agreement Number. <br /> East Grand Stormwater & Sewer G1200541 <br /> AUTHORIZING SIGNATORY - <br /> Signature Print or Type Title/Term of Office <br /> Ray Stephanson Mayor <br /> • <br /> AUTHORIZED TO SIGN AGREEMENT AMENDMENTS . <br /> Signature • - Print or Type • Title <br /> /ji / • <br /> Ai. o David H. Davis Public Works Director <br /> I . <br /> AUTHORIZED TO SIGN REQUEST FOR REIMBURSEMENT <br /> . / Signature ^ ( Print or Type Title <br /> 1 David H. Davis Public Works Director <br /> 44 <br /> ECY 070-206 (Rev. 01/2006) Ecology is an equal opportunity agency. <br />