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AP~IG%TION (~ECK LIST <br />RMQUESTS FOR FINANCIAL ASSISTANCE <br /> <br />N~re of Applicant (if partnership or corporation, <br />  ease give nave of principals and contact persons <br /> different fr~ above) <br /> <br />Addr ess of Appl icant <br /> <br />Phone N~rber of Applicant <br /> <br />Location/Address of Project <br /> <br />Description of Project <br /> <br />Description of P~quest <br /> <br />Estimated Cost of Project <br /> <br />Estimated Cost of Request <br /> <br />Cost Breakdown of Bequest <br /> <br />Site Plan of Project (if applicable) <br /> <br />Total Full-time Per~anent Jobs Created by Project (if applicable) <br /> <br />Is Project an Expansion of Existing Ra~sey <br /> Business? <br /> <br />Tiwetable for Total Project <br /> <br /> <br />