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Countywide Façade Improvement Program Participation Interest Form
1.
Property or Business Name & Address:
2.
Owner Contact Information
Applicant Name
Address
Mailing Address (if different from above):
City/Town
State/Province
ZIP/Postal Code
Country
Email Address
Phone Number
3.
Does Applicant own or lease property on which façade improvements will occur? (choose one)
Own
Lease
Current Purchase Agreement
4.
How long has Applicant owned or been a lessee of the property? (enter number of months and/or years)
5.
Is the property owner minority and/or a woman business enterprise? If yes, please specify.
Minority
Woman-owned
Both
Other (please specify)
6.
Is property currently vacant?
Yes
No
If so, how long has it been vacant?
7.
Check all potential proposed improvements:
Window/Door Replacement
Masonry Repair/Resurfacing and/or Other Exterior Façade Treatments
Exterior Electrical Work
Signage, Awning and/or Lighting
Parking Lot and/or Sidewalk
Permanent Exterior Landscaping and/or Artistic Elements
Other (please specify)
8.
If you decide to submit an official Application that is recommended for the Program, how soon after Application submittal do you anticipate having project design plans ready to submit to DHCA for review?
1-3 months
3-6 months
6 or more months
9.
What is the estimated cost range for your proposed façade improvement project?
Up to $50K
$50K-$100K
$100K-$200K
$200K-$300K
$300K-$500K
$500K or above
