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2. Please read the information contained in the attached document before proceeding.

   Facade Grant Information (PDF)

4. First Name of Applicant*
5. Last Name of Applicant*
7. Street Address*
9. City
10. State
11. Zip Code
13. Phone Number*
14. Email Address
16. Is the owner of the property different from the applicant?*

    1. Yes
    2. No
18. Owner First Name
19. Last Name of Owner
21. Street Address
23. City
24. State
25. Zip Code
27. Phone Number
28. Email Address
30. Project Street Address*
32. City
33. State
34. Zip Code
36. Property/Parcel Number
38. Pre-Inspection Date
    Pre-Inspection Date
39. Final Inspection Date
    Final Inspection Date

    Final Inspection Date
41. Which facades are to be improved?

    1. Front
    2. Rear
    3. Side
43. What is the approximate surface area of the front facade (in square feet)?
45. What is the approximate surface area of the rear facade (in square feet)?
47. What is the approximate surface area of the side facade (in square feet)?
49. Anticipated Start Date
    Anticipated Start Date
50. Projected Completion Date
    Projected Completion Date
52. Total Estimated Project Cost
53. Amount Requested
55. Labor Cost
56. Materials Cost
58. Have you previously received Facade Grant money for this property?

    1. Yes
    2. No
60. Description of the proposed facade/sign improvement.
62. Attach any additional items if needed.
64. Quotes
66. Name of Contractor Providing a Quote*
67. Total Amount of Quote (including taxes)*
69. Name of Contractor Providing a Quote*
70. Total Amount of Quote (including taxes)*
72. The undersigned applicant agrees to comply with the guidelines and procedures of the Facade Grant Program.
74. I, the undersigned, certify that all labor services included in this project application are compensated according to the State of Illinois Prevailing Wage Act. The undersigned, shall be solely responsible to determine compliance with applicable laws, including, but not limited to, the application and payment of Prevailing Wages related to the project, and agrees to indemnify, defend and hold harmless the city in connection therewith.*

    1. I agree.
76. I also certify that the information contained in this application and all attachments is true and correct to the best of my knowledge.*

    1. I agree.
78. Type in your full name.*
79. Today's Date*
    Today's Date
Leave This Blank:


81. 1. Receive an email copy of this form.
82. Email address

    This field is not part of the form submission.

83. Submit

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