Orange County NC Website
APMCA11ON FOR FUNDI NG FOR OONSTRUC11 ON PROGRAMS <br /> Town of Chapel Hill CD®G Program <br /> Orange County HOM E Program <br /> Section 1:APPLICANTAND PROJECT CVSME <br /> A. Applicant Information <br /> Applicant Organization's Legal Name: <br /> Primary Contact Person and Title: <br /> Applicant Organization's Physical Address: <br /> Applicant Organization's Mailing Address: <br /> Telephone Number: Fax Number: <br /> Email Address: <br /> DUNSNumber: <br /> (Dun&Bradstreet, Inc. provides this number at no charge,and it is required for Federal funding recipients.) <br /> B. Project Information <br /> Project Name: <br /> Total Project Cost: <br /> Total Amount of Funds F;bquested: <br /> Please specify the type and an=nt of funding requested: (Note.If applying for HOMEand CDBGfunds, <br /> please indicate the amount requested from each source.) <br /> ❑ CDBG $ and/or ❑ HOME $ <br /> Proposed Use of Funds F;bquested (provide a concise description of proposed project): <br /> To the best of my knowledge and belief all information and data in this application are true and <br /> current. The document has been duly authorized by the governing board of the applicant. <br /> Signature: <br /> Board Chairperson/Department Head Date <br /> Page 1 of 9 <br />