historic preservation officer or CLG representative’s Certification: Signature: ___________________________ Title: ______________________ Date: ______________ Chief Elected official CertifIcation: Application must be signed by the chief elected official of the CLG (e.g. Mayor or Judge) or chief administrative official (e.g. City Manager). Signature: ___________________________ Title: ______________________ Date: ______________
historic preservation officer or CLG representative’s Certification: Signature: ___________________________ Title: ______________________ Date: ______________ Chief Elected official CertifIcation: Application must be signed by the chief elected official of the CLG (e.g. Mayor or Judge) or chief administrative official (e.g. City Manager). Signature: ___________________________ Title: ______________________ Date: ______________