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Il. <br /> <br />IlL <br /> <br />VI. <br /> <br />Vll, <br /> <br />VIII, <br /> <br /> IX. <br /> <br /> X. <br /> <br />XI. <br /> <br />Xli. <br /> <br />XIII. <br /> <br />XIV. <br /> <br />!PRELIMINARY PROJECT REQUEST FORM <br /> <br /> See enclosed shee[s <br />PROJE ,~'~I' NAME: <br /> <br />Senior Outreach Program - City of Ramsay <br /> <br />A. Briefly clescril:)e the proiect <br /> 1. Proiem location (attach a map) <br /> 2.. <br /> <br />:Prolect activities (acclulsJtiort, <br />irehaOllitation, aOministration, etc.) <br /> <br /> relocation, <br /> <br />3, Detail the number ol persons I~enefitting. <br />4. How are they benefit"ting? <br />5. How many persons are Iow income? <br /> <br />construction, <br /> <br />demolition, <br /> <br />PROJECT DURATION: <br />A. Is thls a one, two or three year project? <br />B. GiveiProje~ termination Oate. <br /> <br />the Prc~ie~ is more than one year, detail the project activities by year. <br /> <br />Briefly describe the Community problems that the activities addregs. <br />(For example, neighborhood biigt~t, [a~k of iow income )ohs, subs"t, andard housing.) <br /> <br />SummariZe the tunding. <br /> Total revenue neeCed. <br />B. TotaI~C.D.B.G. revenue neeciec[. <br />C. SoUr~r~ and amount of other revenue. <br /> <br />Detail the cost of each a~ivity (demonstrate how each cast was arrived at). <br /> <br />Briefly describe the project area. <br />A. It.s geographical size. <br /> Number of househotdsl or businesses. <br />C. Adeo. tcac"y of the public facilities (sewers, water, street-% etc.). <br />D, Age of the neighbori~ood, of the homes or businesses. <br /> <br />Is this proje,---t part of a larger effort.? If yes, exptainl <br /> <br />Project contact person: <br /> <br />RESOLUTION OF LOCAL UNIT' OF GOVERNMENT: ATTACH TO FORM <br /> <br />'Individual ~uthofized to request reimbursements 1or proje~ expenses 1rom Anoka <br />Coumy. <br /> <br />A'Fi'ACH A PROJECT SCHEDULE. <br /> <br />Detail any' demolition of housing suitabte for lower income households. New <br />requirements call 1or one-for-one replacement. <br /> <br />(over) <br /> <br /> <br />