Countywide Façade Improvement Program Participation Interest Form Question Title * 1. Property or Business Name & Address: Question Title * 2. Owner Contact Information Applicant Name Address Mailing Address (if different from above): City/Town State/Province ZIP/Postal Code Country Email Address Phone Number Question Title * 3. Does Applicant own or lease property on which façade improvements will occur? (choose one) Own Lease Current Purchase Agreement Question Title * 4. How long has Applicant owned or been a lessee of the property? (enter number of months and/or years) Question Title * 5. Is the property owner minority and/or a woman business enterprise? If yes, please specify. Minority Woman-owned Both Other (please specify) Question Title * 6. Is property currently vacant? Yes No If so, how long has it been vacant? Question Title * 7. Check all potential proposed improvements: Window/Door Replacement Masonry Repair/Resurfacing and/or Other Exterior Façade Treatments Exterior Electrical Work Signage, Awning and/or Lighting Parking Lot and/or Sidewalk Permanent Exterior Landscaping and/or Artistic Elements Other (please specify) Question Title * 8. If you decide to submit an official Application that is recommended for the Program, how soon after Application submittal do you anticipate having project design plans ready to submit to DHCA for review? 1-3 months 3-6 months 6 or more months Question Title * 9. What is the estimated cost range for your proposed façade improvement project? Up to $50K $50K-$100K $100K-$200K $200K-$300K $300K-$500K $500K or above Done
