
TOWN OF
NEIGHBORHOOD IMPROVEMENT PROGRAM
APPLICATION FOR MATCHING GRANT
Please complete all pages of this application in its
entirety and have your representative sign below. This information is needed to determine your
eligibility for the Town of
|
Date: |
APPLICANT INFORMATION
Please indicate the Chair,
President, or Director of your organization and a contact person (if
different). The contact person should be
able to answer specific questions regarding your project and application.
|
Name of Applicant/Organization: |
|
|
President/Chairperson (If
applicable): |
|
|
Address: (Number) (Street) |
(City) (State) (Zip) |
|
Phone Number (Day): |
Phone Number (Evening): |
|
E-mail: |
|
PROJECT SUMMARY
Please indicate name of the project
and the specific neighborhood or physical location of the project. A person authorized by the organization, such
as President, Chairperson, Vice Chairperson, Director, etc must sign the
application.
Signature (&
Date) of Authorized Representative Printed Name (& Title) of
Authorized Representative
_____________________________________ ______________________________________
Please
provide a response to the following questions.
Attach additional sheets as necessary.
|
PLEASE PROVIDE A DESCRIPTION OF THE PROJECT |
|
|
|
DESCRIPTION OF THE APPLICANT |
|
|
Please
provide a brief description of your organization; how is it organized, how
long it has been established, etc.
Applicant should demonstrate how the project will be managed by the organization
and how the match requirements will be met in a timely manner. |
We are
a: |
|
|
|
|
NEIGHBORHOOD INVOLVEMENT |
|
Please
describe how involvement from the neighborhood residents was obtained in the
selection of this project. Include
documentation showing the neighborhood involvement such as neighborhood
flyers, minutes of any meetings where the project was discussed, sign-in
sheets, etc. |
|
WHAT WILL THE PROJECT ACCOMPLISH |
|
Please
describe what need this project addresses and how the neighborhood will
benefit from the project. Will there
be any spillover benefits to the Town?
If possible please provide specific numbers of persons benefiting or
other measures to demonstrate the success of the project. |
|
FUTURE MAINTENANCE OF THE PROJECT |
|
If you
are proposing a physical project such as a neighborhood sign or landscaping
/beautification project please describe how the project will be maintained once
the project is completed. If the
project is organizational in nature describe how you plan to maintain what is
gained from the project after it is completed. |
|
MATCH REQUIREMENTS |
|
Applicants requesting funding
under the Neighborhood Improvement Program must provide a 100% match ($1.00
in matching funds for each $1.00 requested in funding).
The match provided must be directly related to the project being
undertaken. Matching resources may include
the following: ·
Cash
contributions; ·
Donated
or Discounted Materials or Services, provided that price quotes are provided
from the vendor substantiating the value of the item(s); ·
Donated
land, with assessment information documenting the value of the donation; ·
Donated
professional services, such as architectural, engineering, construction,
etc., valued at the full cost of the service provided; ·
Volunteer
labor, valued at $16.25 per hour. Briefly
describe the matching resources you have identified to meet the match
requirement |
|
BUDGET WORKSHEET |
|
The
Budget Worksheet may be found on the following page. The budget should provide a total picture
of your project and the resources needed to complete it. All related costs must be covered in the
budget. The applicant is required to
identify the source of funding for each line item with an explanation if
necessary. The value and type of any
in-kind contributions should be thoroughly explained and should include
supporting documentation as needed. Your
budget should clearly relate to the activities described in your project
description. Instructions
for completing the Budget Worksheet: (A)
Budget Item:
Provide a brief description of each item needed to complete the
proposed project, including labor and materials. (B)
Actual Cost:
The actual cost or value of the item.
Please detail material and labor costs separately where applicable. (C)
Requested in Matching Grant
Funding: Amount of money requested for each line
item from Neighborhood Improvement Program funds (D)
Matching Resources Provided by the
Applicant: Indicate the value of the matching
resources being provided by the applicant through volunteer labor, cash
donations, donated goods or services, etc. Note for Columns (C) and (D): Some budget line items may be entirely
funded by Neighborhood Improvement Program funds or by Matching
resources. Each line item does not
need to show a 100% match. Match
requirements only apply to the total project cost. (E)
Specify Matching Resources: Indicate the source of the volunteer labor,
cash donation, discount in material costs, etc. If donated or discounted materials or
services, identify vendor. (F)
Total:
The Total is the sum of columns (C) and (D). |
|
BUDGET WORKSHEET |
|||||
|
Applicant: Name of Project: UDGET WORKSHEET BUDGET WORKSHEET |
|||||
|
|
|
||||
|
|
Funding Sources |
||||
|
(A) Budget Item |
(B) Actual Cost |
(C) Amount Requested in NIP Grant Funding |
(D) Matching Resources Provided by Applicant |
(E) Specify Matching Resources |
(F) TOTAL (Sum C+D) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
TOTALS: (Column D should
equal or exceed Column C) |
|
|
|
|
|
*Please Note: If your proposed project will change
a part of your neighborhood which is subject to a previously approved site plan
then you will also need to complete a Minor Alteration application
(landscaping, lighting, building facades). This application may be found on our
Plan
Review web page or here.
Please contact Kevin Hales, Site Planner (919) 462-3955, with any questions you
have about this application. The Minor Alteration application has a $50 processing
fee and may be included as one of the items included in your project budget.
Please Send All Completed
Applications To:
Will
Hartye, Planner
Neighborhood
Improvement Program
Planning
Department