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10 <br />EXHIBIT A <br />BUSINESS ASSISTANCE APPLICATION <br />A. APPLICANT INFORMATION <br />Name of Corporation/Partnership ��s,s/'1�Q'/1 ,�L G • Q� �• . C,l144f'(�JPAVoe Pr2Z� <br />Address do I V 5LAA hla'0 d- N VJ lA <br />Primary Contact w'kdni5(a4 5t,1aASD^ <br />Address ba C, P W lZo, se y. MAI 6*C <br />Phone '� 1 fj �q') � N Fax E-mail /� S ufpll Sd� �j C,{�►r1�1 C.� Qr� �� I ZtA •CAr''� <br />Type of business assistance requested (select one): <br />❑ Tax Abatement ❑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 <br />r�4 9 <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 />• Abut for analysis and narrative. Attach as Part 4. <br />• Completed Revolving Loan Fund Application. Attach as Part 5 if required. <br />Attorney Name Th DmQS JL - W e,/i �2,{,r' <br />Address a60 0 C o 12-A1043 i 1 ✓ 4 A to Ll 0 0 V1 M Al <br />Phone (I (A) 1 Fax ('� 3 — 111 E-mail +UJer1+-4e.11A _ bA S• GOW► <br />Contractor Name <br />VVI [*%-) e K ("Vi <br />Address %i 4 D I SA a t4s�'/►A I �V <br />Phon<41i -,,- 5 g 1 (O Fax (WJ 31-;___11qq <br />Engineer Name <br />Address <br />Phone <br />Architect Name <br />Fax <br />Address 1 y ss VM <br />0 <br />Phone�l�3) 59;3 Fax <br />W. <br />%J &rf t <br />u� Dr # I <br />i e Asa r <br />d- 204 ers, <br />E-mail a�%,rinMW'L4QrSO✓1 •CON' <br />\J \,J <br />E-mail <br />/een) <br />LAr0*W LAP? M ICI <br />E-mail Koa (a, +0t el �AartA. co <br />