HomeMy WebLinkAboutV.C.ii__Farmington Downtown Facade Improvement Project Guidelines
Downtown Façade Improvement
Program Grant Application
A BID FROM A CONTRACTOR MUST BE SUBMITTED WITH THIS APPLICATION.
APPLICANT INFORMATION
NAME OF APPLICANT(S)
BUILDING OWNER TENANT
ADDRESS ADDRESS
CITY, STATE, ZIP CITY, STATE, ZIP
PHONE PHONE
EMAIL EMAIL
BUSINESS INFORMATION
LEGAL NAME OF BUSINESS
ADDRESS
CITY, STATE, ZIP
BUSINESS PHONE
FEDERAL TAX ID# DATE ESTABLISHED
OWNERSHIP INTEREST OF ALL PARTIES NAMED ON TITLE:
NAME INTEREST
NAME INTEREST
NAME INTEREST
PROPERTY INFORMATION
WHAT YEAR WAS THE BUILDING ORIGINALLY BUILT
HAS THIS BUILDING BEEN HISTORICALLY REGISTERED?
PROJECT INFORMATION
BRIEF DESCRIPTION OF PROPOSED PROJECT:
ESTIMATED PROJECT COSTS
EXTERIOR/FAÇADE ESTIMATED COST
ELECTRICAL ESTIMATED COST
TOTAL ESTIMATED COST
FUNDING INFORMATION
A 1:1 match is required by the applicant. For every dollar contributed to funding
eligible project costs by the Downtown Façade Improvement Program, the
applicant must contribute at least one dollar. The amount of grant to be awarded
shall be $1,500 up to $10,000 according to the scale.
TOTAL GRANT AMOUNT REQUESTED $ ($1,500 up to $10,000 according to
the scale) APPLICANT FUNDS $
I/We declare that the information provided on this application and the accompanying
attachments is true and complete to the best of my/our knowledge. I/We understand that any
intentional misstatements will be grounds for disqualification and that the city of Farmington /
EDA has the right to verify this information. I/We agree to provide the project coordinator
reasonable access to information and reasonable access to the construction project site so that
they may monitor project implementation.
APPLICANT(S)
DATE
DATE
DATE
A BID FROM A CONTRACTOR MUST BE SUBMITTED WITH THIS APPLICATION.
MINNESOTA DATA PRACTICES ACT—TENNESSEN WARNING
In accordance with the State of Minnesota Government Data Practices Act, the city of
Farmington is required to inform you of your rights as they pertain to the confidential
information collected from you. Confidential data is that information which is not
available to you or the public. The personal information we collect about you is
private.
The information collected from you and from other agencies or individuals is used to
determine the disposition of your application with the city.
The dissemination and use of the data collected is limited to that necessary for the
administration and management of the Downtown Façade Improvement Program.
Persons or agencies with whom this information may be shared, include:
1. City of Farmington personnel administering the grant program
2. City Council members, Economic Development Authority members
3. Contracted private auditors
4. Law enforcement personnel
5. Those individuals or agencies to whom you give your
express written permission
NOTICE PURSUANT TO MS.60A.955