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Address <br />Phone <br />10 <br />EtItiIT A <br />BUSINESS ASSISTANCE APPLICATION <br />A. APPLICANT IN'ORMATION <br />Name of Corporation/Partnership 3 - IQ ems,. <br />Address 5ov . ' me . P <br />Primary Contact <br />Address <br />Phone <br />• <br />p.0. Jite..x '3i0 .�- <br />1 <br />arc <br />Type of business assistance requested (select one): <br />❑ Tax Abatement ETax Increment Financing LlRevolving Loan Fund ,ether <br />M <br />Have you been, or are you currently, involved in any bankruptcy proceedings or lawsuits related to <br />other development projects with which you have been involved? if yes, please provide an <br />explanation. <br />Yes No <br />On a separate sheet, please provide the following: <br />• Brief description of the corporation/partnership's business, including history, principal product <br />or service, etc. Attach as Part 1. <br />• List names of officers and shareholders/partners with more than five percent (5%) interest in <br />the corporation/partnership. Attach as Part 2. <br />• Brief description of the proposed project. Attach as Part 3. <br />• A but_for analysis and narrative. Attach as Part 4. <br />• Completed Revolving Loan Fund Application. Attach as Part 5 if required. <br />Attorney Name CA) INN*11,-re welt, 5-1;$ INA.. /Jot 5eArwhs,t,„ 14101.029416 (pa tikAlur <br />Address 2-A 5;NiCirls., $114r45e.. )s. W1.d '. S .., 5 .. . 3S°c, <br />Phone <br />r <br />Contractor Name Po le. EA, I C m.Q 1Pve, i�e,5 ,j3 v. ; <br />7 et tz) ik1/44..rt__ 5 If Hoc. mit). 55i/3,c <br />Engineer Name ?Ifou.)6k. Evkco ���;,,` C (AA P W <br />(0?76 L.% gle, 0s=to L SaI4 <br />Address <br />Phone <br />Architect NameLI }{-� L h �C � r 7u� -• (V� �i f< 1� L <br />Address 136.1 � � � o v� Ave. (.4) 3 w5 3C�/V� N_• 553'7 5 <br />Phone <br />