Provide a brief project description:*

Building square footage*

Size of property:*

Materials and other additional relevant building information:*

Provide a brief description of your business:*

Business Name:*

Address:*

Telephone:*

Contact Name:*

Email Address:*

Provide information on the present ownership of the building:

Name:*

Address:*

Phone Number:*

Contact Name:*

Identify Estimated Qualified Project Costs for the following:

Exterior:*

Signage:*

Awnings:*

Other:

TOTAL ESTIMATED COSTS:*

Provide Estimated Project Funding for the following:

Private financing institution:

Building owner equity:

Other public funds:

TOTAL ESTIMATED SOURCES:

(Should equal Total Estimated Costs)

Are Real Estate Property Taxes Current?

Yes

No

Provide Estimated Construction Rehab Start Date:

Provide Estimated Construction Rehab Completion Date:

Provide pictures of project before start:

Convert to PDF?
(DOC, DOCX, XLS, XLSX, TXT)

Please provide drawings/sketches of project completion:

Convert to PDF?
(DOC, DOCX, XLS, XLSX, TXT)

How will rehab activities enhance the value of this property and surrounding businesses?*