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EXHIBIT A <br />BUSINESS ASSISTANCE APPLICATION <br />A. APPLICANT INFORMATION <br />Name of Corporation/Partnership Z Cr.() <br />Address <br />6/5! !Noth Ave. No/ <br />Primary Contact Ph,'! pt /B, s-0 <br />Address , IS / ! <br />Phone 3y g - / q q (� Fax <br />��lb <br />10 <br />th'c F+I <br />Z.o,1C of"+. cP-0•71.'�, Z- 4- C. <br />/✓ ss 30 3 <br />ke_t AO <br />fh N <br />RA/))Seri ✓hN 5 303 <br />E-mail ot: sett,: 0cto " Zn`-e. 4,04k <br />Type of business assistance requested (select one): <br />❑ Tax Abatement [I'ax Increment Financing ERevolving 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 y4,No <br />On a separate sheet; please provide the following: <br />• Brier description oldie 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 />• Cotnpleted Revolving Loan Fund Application. Attach as Part 5 if required. <br />Fob( oW 1'// 41.31 SA.>7.nnon Kov*r,Vs <br />Address ,(�J"?A A/ v`J-ic.,- f/t'_fre,IDGD �'l'iv vKee ..1 . .�320 <br />Phoney 1) n3" 31 3 C Fax <br />Contractor Name giv UC /` 19'4s.9- <br /><1 <br />Address P 1030 a?+J,S*/- <br />Phone(i 3) clir(' %t 0 Fax <br />Engineer Name <br />Address <br />Attorney Name <br />Phone <br />Architect Name <br />Address <br />Phone <br />Fax <br />Fax <br />E-mail <br />id <br />E-mail 13r -'► ,-,Gd'✓r1 <br />E-mail <br />