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Ject Name 1. Reference Numbers CEQR REFERENCE NUMBER (To Be Assigned by Lead Agency) BSA REFERENCE NUMBER (If Applicable) ULURP REFERENCE NUMBER (If Applicable)) OTHER REFERENCE NUMBER(S) (If Applicable) (e.g. Legislative Intro, CAPA, etc) 2a. Lead Agency Information 2b. Applicant Information NAME OF LEAD AGENCY NAME OF APPLICANT NAME OF LEAD AGENCY CONTACT PERSON NAME OF APPLICANT S REPRESENTATIVE OR CONTACT PERSON ADDRESS ADDRESS CITY STATE TELEPHONE FAX ZIP CITY E.

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