Downtown Connellsville Design Grant Application www.downtownconnellsville.org
Downtown Connellsville Design Grant Application Applicant’s Name: _____________________________ Business: ___________________________________ Project Site Address ___________________________ Mailing Address: ______________________________ Business Phone: ______________________________ Business Fax: ________________________________
For Downtown Connellsville Use Only: Date Application Received: By:______________ Target Area Location Yes_____ No_____ Code Compliance Yes_____ No_____ Financial
Business Email: _______________________________ Responsibility Are you the owner(s) of record of the subject property? Yes _____ No _____ Property Owners Name: ________________________ Project Owners Address: ________________________ Project Owner’s Phone: _________________________ Brief Project Description: Please provide a description of the project, goals, project timeline. Attach any additional description/documentation. ____________________________________________ ____________________________________________
Yes_____ No_____ Signed:___________ Downtown Connellsville Program Liaison Connellsville Main Street: ________________ Date:____________ President, Downtown Connellsville: ________________ Date_____________
Estimated Project Cost: ________________________ Indicate the appropriate category associated with the project: (Please circle all that apply)
Design Committee Approved Yes_____ No_____
_____Signs/Awnings
Connellsville Design Committee Chairperson:
_____Exterior Painting and Restoration
________________
_____Additions and Architecture Elements
Date:____________
Site and Building Enhancements _____Paving and Sitescaping _____Walls and Fences _____Exterior Lighting Anticipated Project Start Date: ___________________ Additional Funding Source(s)- (Circle all that apply): _____Cash _____Bank Loan _____Other (Please specify and describe below) ____________________________________________ ____________________________________________ The applicant acknowledges the terms and conditions associated with the Faรงade Restoration Grant Program and agrees to comply with all of its requirements. Signature of Applicant: _________________________ Date: _______________________________________ Signature of Property Owner of Record (if different from above): _________________________________ Date: _______________________________________ Submit grant applications to: Downtown Connellsville 139 West Crawford Avenue Connellsville, Pennsylvania 15425
Faรงade Grant Application Downtown Connellsville If you have any questions regarding the completion of this application or the eligibility of your project, please call the Downtown Connellsville Office at 724-626-1645.
Release and Hold Harmless Agreement For Connellsville Faรงade Grant Program Release executed on the ____________ day of _____________, 20___, by __________________________ and ____________________________ of _______________________, Property Owner _______________________, (Tenant if applicable) ___________________________________________, Street Address ________________________________________________. City of Connellsville, Fayette County, State of Pennsylvania, referred to as Releaser(s). In consideration of being granted monies for restoration, modifications, signage or other physical changes to the property located at the above address, the Releaser(s), understands that they are solely responsible for providing their own contractors and to assure that those contractors are fully insured and licensed and have obtained all necessary permits in accordance with Borough and State regulations. The Releaser(s) waives, releases, discharges and covenants not to sue the Downtown Connellsville program for loss or damage, and claims or damages therefore, on account of any work that has been performed in accordance with City or State guidelines. Releaser(s) agrees that this release, waiver, and indemnity agreement is intended to be as broad and inclusive as permitted by the laws of the State of Pennsylvania and that if any portion of the agreement is held invalid, it is agreed that the balance shall; notwithstanding, continue in full legal force and effect. Releaser(s) further states that it has carefully read the above release and knows the contents of the release and signs this release as its own free act. Releaser(s) obligations and duties hereunder shall in no manner be limited to or restricted by the maintaining of any insurance coverage related to the above referenced event. This release contains the entire agreement between parties to this agreement and the terms of this release are contractual and not a mere recital.
Date this __________ day of __________, 20____. Property Owners Signature:_____________________________________ Witness:____________________________________________________ Tenant Signature (if applicable): _________________________________ Witness: ____________________________________________________