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10 <br />EXHIBIT A <br />BUSINESS ASSISTANCE APPLICATION <br />A. APPLICANT INFORMATION f <br />Name of Corporation/Partnership l_/ ppi 1-- <br />Address (06 {Nm-8e 1� �'r9Ai f xesgtStatz - .5-3s] <br />Primary Contact �/-✓' r k? <br />Address <br />Phone g cZ pot 611 25'a 791( <br />Type of business assistance requested (select one): <br />❑ Tax Abatement J[Tax Increment Financing ['Revolving Loan Fund ❑Other <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 XINo <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 g =)4 V4D S'Tr <br />Address ( <br />Phoned52.. 9.94( r'a Fax <br />Contractor Name <br />Address <br />Phone 65/ 3 7" 3 Fax <br />E-mail <br />743 et. p,1W O r. 0 <br />opeioAP Comet. CoL- <br />Engineer Name <br />Address <br />Phone 651 6113 OVA Fax <br />y <br />� <br />Architect Name Pip 141g5e J <br />Address -_ <br />Phone 152 7Ya, l Fax <br />E-mail Optf1/ O' ' C.4i►N <br />�G G4c k <br />E-mail ...1 (. orke`r i c j i <br />t <br />0;ick..r 1,2j fiu <br />E-mail Ai 1 kt:. &Ain`t? C <br />icmtvito <br />E-marl <br />epM <br />