Loading...
CDBG 1991 r ^— BOARD OF COUNTY COMMISSIONERS 1 T= MAYOR, Wilhelmina Harvey. District 1 0 U N T Y M O N R O E .- Mayor Pro Tem, Jack London. Distnct 2 - 'A� c Douglas Jones, District 3 KEY WEST FLORIDA 33040 y -'� • __ A. Earl Cheal, Distract 4 (305) 2944641 John Stormont, District 5 IP V7 1 M E M O R A N D U M TO: Robert L. Herman, Director Growth Management FROM: Deanna S. Lloyd, Grants Manager Office of Management and Budget, x4474 DATE: May 21, 1991 SUBJECT: Community Development Block Grant 1991 The following items are included in Monroe County's CDBG application and are on file in my office: 1. Certification by County Clerk 2. CDBG H -1 Applicant Checklist and Application Summary 3. Copies of the 35 surveys conducted on homes located in Hibiscus Park, Key Largo, and The Rock, Marathon 4. Correspondence: Dept. of Community Affairs South Florida Regional Planning Council In -house (Monroe County staff) 5. Resolutions: Citizens Advisory Task Force Authorization to submit application Update on the Tenant Assistance Policy 6. Public Hearings (2) - Proof of Advertising and minutes from the meetings. 7. Notice of Monroe County's proposal - subject to public comment This information and file is available for review in my office. • { CDBG -H -I1 CERTIFICATION BY CITY, COUNTY, OR TOWN CLERK 4. 11 displacement of any persons or businesses will take place as a result of CDBG funded activities evidence that a plan for mitigating the expense of such displacement has been adopted. Date Adopted 7-95-RS 5. Evidence that the local government has submitted information, as required, to the Regional Planning Council. Date mailed 11- 28-90 6. Evidence that the local government has adopted procedures which provide response to complaints and grievances. Date Adopted 7/25/86 7. Evidence that the local government has met the needs of non - English speaking residents in case of public hearings where a significant number of non - English speaking residents participated. Not applicable. 8. Evidence that the local government has complied with the local comprehensive planning requirements of Chapter 163, Florida Statutes for the activities proposed under this project. Tentative Adoption Date: Date plan adopted 2 (if applicable) Date plan approved by DCA — (if applicable) Date plan approval appealed — (if applicable) Date project activities reviewed for local comprehensive plan compliance 11/1/90 1, the undersigned, certify that all citizen participation requirements have been met, a community development plan has been developed, surveys have been conducted and a displacement plan written has been written and adopted. I further certify that all such evidence is on file in my office. I understand that failure to submit complete and sign this certification will result in a 50 point score reduction. t q/ Monroe County Clerk 2 ye_ (/ i-t , ty, or Town erk 7 Date Seal (20) CDBG -H -1 APPLICANT CHECKLIST INSTRUCTIONS: This form will function as a table of contents as well as a scoring summary. It should be completed last, utilizing scores from each of the forms identified below. After completing the remainder of the application, enter scores under the column below marked "Score" and the corresponding page numbers for each of the forms under the column below marked "Page ". Total "Score" column, including the community -wide need score. Enter this figure as "Subscorc ". Page Score CDBG -H -1: Applicant Checklist 1 CDBG -11-2: Application Summary 2 -3 CDBG -H -3: Project Impact (95 points) 4 -5 95 CDBG -H -4: Scope of Work- Benefit 6 -8 CDBG -H -5: Scope of Work- Benefit Summary (555 points) 9 555 CDBG -H -6: Historic Preservation Questionnaire 10 CDBG -H -7: Equal Opportunity Employment (100 points) 11 inn CDBG -H -8: Maps Checklist 12 Jurisdiction Map 13 Project Area Map 14 Flood Plain Map 15 CDBG -H -9: Preapplication Survey Form 16 -17 CDBG -H -10: Other Jurisdictional Activities 18 CDBG -H -11: Clerk's Certification 19 -20 CDBG -H -12: Statement of Assurances 21 -23 Signed by Chief Elected Official or Authorized Designee CDBG -H -13: Statement of Application 24 Community -Wide Need Score (250 points) CO _88 SUBSCORE ni n _ 83 DCA USE ONLY: Past Performance per Rule 9B- 43.006(7) SCORE (1) CDBG -H -2 APPLICATION SUMMARY 1) Applicant: Motes Courtty 2) Address: Monroe County Public Service Building, Wing II, Room 214 Stock Island, Key West, FL 33040 3) County: Monroe County 4) Name of Chief Elected Official: (Type) John Stormont 5) Contact Person: George Harper 6) Phone #: 305/292 -4469 7) Agency or Firm that Prepared the Application: Langton Assoc., Inc. 8) Phone #: 904/387 - 3342 9) Address: 4244 St. Johns Avenue, Jacksonville, FL 32210 10) TYPE OF APPLICANT: Individual X Joint (See Rule 9B- 43.004) 11) TOTAL FUNDS REQUESTED: $ 650,000.00 12) CDBG Administrative Costs: $ 97,500.00 13) Percentage of Administrative Costs: 15 % (CDBG Admin. Costs = Total Funds Requested) /Rule 913.43.006(4)1 14) Project Cost: $ 552,500.00 (Total Funds Requested - CDBG Administrative Costs) 15) Other Non -CDBG Project Funds: $ 11,000.00 16) Total Project Cost: $ 563,500.00 (Project Cost + Other Non -CDBG Project Funds) 17) One household must directly benefit for each $25,000 in CDBG funds expended. $ 650,000.00 - 35 = 18,571.43 Total Funds Number of Amount per Household Requested Households /Rule 9B- 43.009(6)1 Benefiting 18) Does the applicant have an open Economic Development Grant? No 19) If you are submitting an application in more than one grant category (i.e. Housing, Neighborhood Revitalization or Commercial Revitalization), excluding Neighborhood Revitalization Emergency Assistance Set - aside, and if all of the applications are In the fundable ranges and would receive full funding, which grant do you prefer to be funded? N/A 20) PROJECT AREA DISTRICTS: U.S. Congressional District Number: 19 Florida Senate District 39 Florida House District: 120 Census Tract Enumeration District 12T, 21,22 23,24 T -U 25, 2G T -U (2) CDBC -H -2 APPLICATION SUMMARY 21) Is this project in a 100 -year flood plain? Yes If yes: a. How will this project comply with local building codes? The proposed projects lie in one of Florida's Area of Critical State Consern and must comply with FEM requirements, as well as the Standard Building Code. b. Do the cost estimates reflect any increase which may occur due to the location of activities within the flood plain? Yes 22) Narrative Description of Proposed Project. If complementary activities are proposed describe how the activities relate to the project as required In Rule 913- 43.003(11)(a). The primary objective of this application is to improve housing conditions and opportunities for very low- income citizens through the substantial rehabilitation of 35 housing units in Hibiscus Park area and an area called "The Rock" in Marathon. This project addresses National Objective A by providing a 100% very low income benefit. No displacement will occur. • (3) CDBG -H -3 PROJECT IMPACT This form is representative of the total project. Complete only once. A. EFFICIENCY AND EFFECTIVENESS IMPACT Al. PROJECT EFFICIENCY IMPACT: Total Amount of CDBG funds Requested _ 650,000.00 18,571.43 Total Number of Housing Units 35 Unit Cost Addressed by the Project Points awarded for Unit Cost correspond to the following categories: Categories Points $22,000 to $25,000 10 $21,000 to $21,999 2p $20,000 to $20,999 30 $19,000 to 19,999 40 $18,999 and under 50 (SCORE) A2. HEALTH AND SAFETY IMPACT: The following formula will assess the percentage of housing units addressed by this project that have a health and safety need. (Please refer to Preapplication Survey Form, CDBG -H -9) # of Housing Units in this Project with Health and Safety Needs 35 100% Total # of Housing Units 35 Health & Safety in this Project Percentage Points awarded for Health and Safety Percentage correspond to the following categories: Categories Points 90% and Greater 40 80% to 89% 30 70% to 79% 20 60% to 69% 10 50% to 59% 5 40 (SCORE) (4) 1 CDBG -H -3 PROJECT IMPACT B: LOCAL GOVERNMENT IMPACT INSTRUCTIONS: Select either B1, 82 or B3 for a total of five (5) points. B1. ALTERNATIVE FUNDING EFFORT IMPACT: Five (5) points will be awarded to an applicant that has applied for community development grants from either: federal, state or private foundations; or has formally participated in a local community development attempt to receive either: federal, state or private foundation grants. The funds must have been applied for within the last twelve (12) months before the notice of CDBG funding availability is published. Applicable community development grants are those that specifically address activities that would be eligible under this grant category. The cover page and the chief elected official signature page of the grant application(s) must be attached to this application to receive the applicable points. If applying for points for participation in a local community development organization's attempt to receive funding, the local government must also submit a copy of a letter of support or cosponsorship that was issued during the local community development organization's application preparation. Page number for the attached grant documentation or B2. ADMINISTRATIVE EFFICIENCY: Administrative Funds Requested from CDBG Total Administrative = Administrative Amount Allowable for Grant Efficiency Percentage (15% of Grant Request) Five (5) points will be awarded for an Administrative Efficiency Percentage that is equal to 90% and below. or • B3. ADMINISTRATIVE EFFECTIVENESS: Amount of Local Administrative Financial Support = 11,000.00 10.14% Total Administrative Funds = 108 500 Administrative Used for Project Funding Percentage Five (5) points will be awarded for an Administrative Funding Percentage that is equal to 10% and greater. Indicate which option chosen (B1, B2, 83) 83 5 (SCORE) (5) CDBG -H -4 SCOPE OF WORK - BENEFIT INSTRUCTIONS: One CDBG -H -4 form must be completed for EACH activity for which funds are requested. Activity names and numbers for use Iu completing this form appear on page 9. After completion of each activity form, totals should be entered on the Summary form found on page 11. All calculations must be rounded to the nearest 100th. Round 5 and above up. 1) Activity Number 051 2) Activity Name Housing Rehab 3) Type of Unit HU 4) Budget Amount 552, 500.00 5) Other Non -CDBG Funds $ -0- (This activity only) (This activity. only) 6) PERCENT OF TOTAL PROJECT COST: Line Item Budget Amount + Other Non -CDBG Funds (4 + 51 = 552,500.00 = 100 °,%, Project Cost (See #14, p. 4) = 552,500.00 7) # of units to be addressed: 35 (Use Survey Data) 8) # of Low and Moderate Income Direct Beneficiaries of this Activity: 143 (Use Survey Data) (Include Very Low Income Direct Beneficiaries in this calculation) 9) # of Very Low Income Direct Beneficiaries of this Activity: 143 (Use Survey Data) 10) How will units be addressed by this activity, including complementary activities? The 35 units will be rehabilitated to the Standard Building Code. • 11) List the national objective to be met by this activity and describe how it will be met. 'See Rule 9B- 43.006(2)(b)] This activity will meet National Objective A by rehabilitating 35 units occupied • 100% very low income persons. 12) Are there any pre -1940 housing units to be addressed? Yes X No (If yes, please complete CDBG -H -6, page 12) MEASURES FOR ELIGIBLE ACTIVITIES. When making reference to the following activities, they must be stated using the below stated measurements. Please use the appropriate abbreviations. Activity Type of Unit Abbreviation Acquisition Square Feet of Site or SF Number of Housing Units HU Demolition Number of Housing Units HU Clearance Square Feet of Site SF Code Enforcement Number of Housing Units HU Number of Housing Units HU Historic Preservation Number of Housing Units HU Housing Rehabilitation Number of Housing Units tI Payment for Loss of Rents Number of Rental Units RU Permanent Relocation Number of Persons P Temporary Relocation Number of Persons P (6) CDBG -H -4 SCOPE OF WORT: - BENEFIT Al. VERY LOW INCOME HOUSEHOLD IMPACT: Total Number of Very Low Income Housing Units to be Addressed by this Activity = 35 100% Total Number of Housing Units to = 35 be Addressed by this Activity P I Pee rr cennttage age 100% X 100% X 220 = 220 VLI Impact Percent of Total (SCORE) Percentage Project Cost (See #6, p. 8) A2. LOW AND MODERATE INCOME HOUSEHOLD IMPACT * : Total Number of Low and Moderate Income Housing Units to be Addressed by this Activity = 35 100% Total Number of Housing Units to = 35 be Addressed by this Activity er P Impact Percentage 100% X 100% X 145 = 145 LMI Impact Percent of Total (SCORE) Percentage Project Cost (See #6, p. 8) * The number of Very Low Income Housing Units should be included i the number of Low and Moderate Income Housing Units. in B. GOALS: Rule 9B 43.009(3). Use the appropriate points for this line item only in the calculation below. ACTIVITIES FOR GOAL POINT DETERMINATION. DO NOT USE COMPLEMENTARY HOUSING ACTIVITIES AVAILABLE POINTS 029 Clearance 039a Temporary Relocation 110 039b Permanent Relocation 190 041 Payment for Loss of Rents 170 051 Housing Rehabilitation 145 190 053 Code Enforcement 055 Historic Preservation 100 100 071 Demolition (in support 170 171 Acquisition ( pport of housing activities). 170 100% X 190 = 190 Percent of Total Available Goal Points (SCORE) Project Cost (See #6, p. 8) (7) _ i SCOP OF r u ' each cost item be l o w for cost.) fete the table administration UDGET ANALYSIS � Comp not includ eluded in this activity. Unit Total Cost Cost Standard U Used for �ivitY Number of Units Cost per Estimate Previous coast. ons MINIZAIN IIIIIIIIIIIIIIIIIIIIIIIII M NEM .191111111111111111111111111111111 IIIIIIIMEI I .e llilli"IlligNIIIIIIII 1111111111 I.I■MmiMM.M./11111111111111111111111111111111 II IIIIII I IIN IIIIIIIIIIIIIIWIIIgllig 1111111111111.1.11.11110111111111111111.0.11111111111110001111 , WO ; 552,50 _ ma _ 15,7 computati bid i51 C DBG - H -S ( i CDBG -H -5 SCOPE OF WORK- BENEFIT SUMMARY FORM INSTRUCTIONS: Enter scores from each Scope of Work - Benefit Form (CDBC -H -4) on the chart below. ACTIVITY HOUSEHOLD IMPACT GOAL POINTS TOTAL SCORE NUMBER Al A2 B 051 220 145 190 555 r` TOTALS: SUBSCORE: 220 145 190 555 s (9) CDBG -H -6 HISTORIC PRESERVATION QUESTIONNAIRE (Complete ONLY if pre -1940 are addressed) 1) What kinds of activities are included in the project? a) Housing rehabilitation: Yes X No b) Housing demolition: Yes No X c) Other (describe): 2) Have you included a map with the location of proposed activities? Yes X No 3) If any structures constructed prior to 1940 will be affected by this project, please provide original photographs of such structures for review to assist in determining their historic - architectural significance. The photographs should be identified by street address and should be keyed to the properties identified on the map. If potentially significant historic sites are identified, the Stag Historic Preservation Office (SHPO) will recommend appropriate action. 4) List the street addresses of identified units: 1. NJ A 2. 3. 4. 5. 6. 7. 8. 9. 10. (10) CDBG -H -7 EQUAL OPPORTUNITY EMPLOYMENT I. Equal Opportunity Employment (EOE). For Joint applications, data must be calculated for each eligible applicant and the Total scores averaged. Equal Opportunity Employment of Minority Persons. (30 points) Total number of permanent full -time local government employees 1176 Number of permanent full -time minority local government employees 176 Percentage of minority employees 15 %. Percentage of minorities in jurisdiction 4.15 %. INDICATE CHOICE X A. Thirty points will be awarded if the percentage of permanent full -time minority is equal to or greater than the percentage of minorities within the jurisdiction. - or - B. Thirty points will be awarded it there is only one or no local government permanent full -time employee. - or - • C. Thirty points will be awarded if the percentage of minorities in the jurisdiction is less than 1 percent. -or - D. If the percentage of minority employees is below the percentage of minorities in the jurisdiction, points will be computed by dividing the percentage of minority employees by the percentage of minority residents and multiplying by 30 points. Round to nearest 100th. Round 5 and above up. Percentage of minority employees: Percentage of minority residents: X 30 pts. A, B, C or D Score 30 pts. 11. Fair Housing. Applicant has adopted a fair housing ordinance, prior to the submission deadline date, which is consistent with State and Federal Fair Housing laws. (35 points) Date ordinance adopted 7 / 25 /86 Score 35 pts. III. Affirmative Action. Applicant has adopted an affirmative action plan, prior to the submission deadline date, which includes procedures for hiring minority contractors. (35 points) Date plan adopted 12/15/87 Score 35 pts. TOTAL EOE SCORE (Add Sections 1 through III): 100 (100 points) (11) CDBG -H -8 MAPS CHECKLIST A. JURISDICTION MAP must be clearly legible and fulfill the following requirements: Map attached as page: (a) Contain a scale which is clearly 13 marked on the map (b) Show boundaries of the locality (c) Show the approximate location of units to be addressed B. PROJECT MAP must be clearly legible and fulfill the following requirements: Map attached as page: 14 - 14a (a) Contain a scale which is clearly marked on the map (b) Show the location of the units to be addressed (c) Identify the households that were surveyed. Display the households that are direct beneficiaries. • (e) Include the names, streets, route numbers or easily identifiable landmarks where all activities are located C. 100 -YEAR FLOOD PLAIN MAP must be clearly legible and fulfill the following requirements: Map attached as page: 15 - 15a (a) Display the location of all units to be addressed. NOTE: In accordance with Rule 9B- 43.006(3)(e)3, failure to submit any of the maps Hill result in a 25 point score reduction. (12) TARGET AREA MARATHON " THE ROCK " R LEWIS EARL 8 GRACE CARTY i ETUX., ETAL A.C. SAYLES E UX. kiAYLE S ' J(TYARO ` \`�� B0 ` 4 a 0 111111 :1 ECM • �� GRAC JONES I "� "� ►■� COMMUNIT DAY CARE SIG eoARO ov ti Reuc °' C ENTER l.OUISA STREET A , W as ormu MIIIIMarei �lg9®SEE AMA X N [A900i1CL OIRC M ■C "E YNAY f ga000 JD WAGNER TRACT A 11111 1111 Ilif , Scale: u. s. HWY. 1" = 80 ■ ti 1 p ` I • i O \ F ' "•••-***.' . . .. a• 1 I 412: v , 1 1 . . I i I i' t if lam., •' f I • tae 1t .r i' 1 _"i. 'N 1 5a.. c+ ' I. 41 . _ = ", Willi 1113111.monms m I. DJ ' Ti • P • � - iw %: °.. n C — I ' Ili �: o " c _I ',. ;,:. ills; ---,: i r.1:1 ,t:-.:: •-• t • Cf-' ; : .--a. i. I; '; _ - • � ' i : l ■ -- P : ..i•. ;. L r A f� ti ' L . —N L p.-1:::- r M M 1 ,, m Z . 7 i 1 . 6 iw }� (•� � yr• • `� C 1 !• ';:iii � w . ^ y w • �•, <. I• .1 tit - = s i , ' 1l = -. R + - : 1••` r .7 ./f- ] 1 1 1 y�r = ' - : l 1 .; . . :p F > cl 1 ^� i v 11 0 ui 1 1 1 - , :: t '1 i� �• n 1 .s :!•..•� _ -te i 4 : . i I 1 : •a , ,, Tt- i L.: ::: .. ' p, ir4 1 ;_%•Iti•:-.:•1:-1.t . 12:. I ` •I ; B 1 c I ! ® SPEC FL HA REAS INUNDATED BY lOD• Y EAR FL ZONE A No base fl ood oru dcused j ZONE A Base LEGEND flood elev:":"::::0A:::1: deco mused. 1 ZONE AH Flood d<Dtns 3 lac (uwa11Y caf of t i onm {I; base ekvauons deterum,rsed. x V t � } f(s« I a a +g '( 1 O4 E AO Fb.d deems to 3 tat (uwally . soar r `I y d r ,� Flo on floD rerrun1 tum avwaae seDms j t r i t ,. ,1 dew mNed. or usa3 0f all tan flood - `� k 6 2 Ni, retpelnef F also Oeternl,ned. " r r i To D pr otected from f W- reso by ' f }�. ,� t } t t M .� �, l Z 1 ZONE A99 Fed eral Hood Drore ,.um oar 3r „ • ��'g < c ( r� "�1. cons pycuo n; n oDadec k . an „W f' e >*4'31 T 'L ¢ ri .� s'1' • • • ' t ' l /'�'� Coaual Hood * aescrty nata (rave k �, t y , +r r , .�� I. `a w' ZONE V action) no base float ete.auon decd• z:. i >l i 0 r , ^ , r /� ,/� maned. � 4,:..,', ' � . .. - .el / f t1oo0 rM velocny farad (rare .....w.• ZONE VE C.o+ttal +; 'l � $� � �/ �' � � daw n): base float ekruions atammW , 4F° a h ¢;. v �� c r y ,,;' FLOODWAY ARE IN ZONE A E r •. t 4 ` � l �r ti r J • ZONE � t..� e. �. � � � F; i �`� -. � ��..�/ _.4 a j .. • OTHER FLOO A REAS (( L 7t i . =a l III X A reas of SOO ur flood; ue as m - f bf r f ts 9 , /{ 1 0 0•Y CU flood with Herdi d cp500 tn> v t � Sv f Ix , �'r ,r l 4 / �I o f les [h an 1 foot or wlth dre,nas f �... { . 1 t e .e,r.�c ' a less t 1 square mil and ZON YE s � ` B j p k ( r ''''f";,;''. t , _ area prote by Icaee> lro 100 (EL 14 ) f ' a y p y FF 4 3 � R �.. w � ^ a �” ._.r.- yea Cloud. "L ,pa '•,/ OTHER ARE 6L ,,,, , t ', , ,A . E ZONE X A re as d e to be ne outvd 1 d If � , 'r 9 1 .„,,,,,,,i;.,%. ; d y I yea flo pla ( y i.,,„ t 1 ( ta r te . _ - ZONE D :: reu in which floo hu ard are F' a r • "ii �y ' n deter m ine a d. d�,p° I - r ) 1 I ! • ° 7 y s� c �' F Bou nduy I — Floodwa Boundar ��a'f s¢ ;,,.....-4, rl(b1�"'� •` ..... � - Zo D Bound ' C 7 1)r. t 4 I {14� �9 undry vldi Special ood , a is 7 3t,� T 1 '•: , ' aLt H uud Zone and Boundar ,rri" A I ��� D ividing Areu of Diffe Fl ren G a { ' C 3�' s • ' "'` $ j C Base F Elevations t l''.+',4;'''';', � - f' ,. " � r. W ith i n Speci Flood Huu y ak % °°''spa"` ' a- ) - - Zones. u .1:,t1 ���;t ° - ! Base Flood Elevation Line J € 7'. +� 51 va tion in Feet• r t' °�(t "t7d r } , 3 , O Cross Sectio Li ne 1 Z ta } ° Base F lo od E levauon in a p _, � � �, x�t g > t .._. � - (EL 98 Whe U nitor r n W I SYI'. f Y "+ � , a tz ` ` a `.,a.. RM7 Elevatio Retercnce Muk t „+, Y' u ' ,. '`, h 4 .: 1 a ' . , ;f r • M: x Rrver M E x i Hi ttwaY Mile in,4 ; ,r.,,,-s' ° - ferrete w the Nat ional Geode( Vertical Datum of 1 I �, a�� t. �� � N O T E S m a p a for u >e m au mmutrrrs tot re iii .v r+•r, , '* f .,Y Y tl do n ot r>ec e»ar,ll ulen1 l all ar >..Gr s1 lv I I:Z9;on,2°,F,9,Encii,aleae,...:t-din. 1 '+ ��' ic fro l oca l drainage sources of >mall >,ze, } • ("" I . tmetn fe atures outs,de pec Flood Hazard Aas • ai 5 � I �- rs not rn Speual Flood Hazar Are as ma y pectd I f b ro strtur . �F ' ,t i s i i / ! ndane o the Iloodways w er e computed at uov secti r )7•f a • - res tat e d c betwee cross sectio al T he doodw br a s s ee b f 3' 4 " ^l�'' i auhc cons,derat, wuh S r es ar d to rrq uurmrnt> a the la- d 2 } t o -.,1''..,1 � tern •rgenq• Manag Agency t ¢ t1,;' 1¢ , R "P'' �` °l • I r I .wt mr aas may be too narr to >how 10 x ale ,.; i r - bJ r �`� { j v t floodway n o Uata Table rr wea& w�dlh n sho wn at ' ,1 ; �" ` f t l - c 1 inch. x } a ; a � { � I al base ay fl ood e app o n l y 1 ndward of the shor rlinr ?•� %- .) ., . , s , (' S `'" . y � �ation refewidren marks are de>cnbrh d re floodw 'n he F l oud Imu Stuo f +r .k ? � fi t ro rt s a r+ 4 i v f rate limns sho are current as of he d ate of lhu ma p 7 hr t} t yea}.. $ i {, r s I sold ontac ap commury o n:a ial> to det ermine wra l r-Qf a. l � + , � I 1 p rporate mrts ce have changed su bsequnt to the o>u ante o this �O ; Y ! s no to countwide maPV n £ a; � • � � f k � }s� I com P an el revision h p s! T u� ` ' i � + ,� t sectio 0 o the Fl oo d Inste u tuds Report y i F < r 1 / adlo n see spa prted ntap Inds fi ° "'- ''i ( s I / N1AP REP RY 5 a1T'f {{ !; to R epository L i>hng on Ma p Indev •5 F't2Kf 4 y J F 1 a A 43bi, �} r 1 Y x~Pt ? , • x +' 4 p, " i y • ' / E FFECTIVE DATE OF COUNTYWID , + t, i t 3 ) ( { °;.+� p � FEDOD INSURANCE RATE ntAP ; F kl r a r ?F �1. ' f a y Ocwb 17 , 1'f i >' ` '� g ' , ' ;, . I l k TM c # > � ( I EFFECTIVE OATE(SI OF REVISIONS TO THIS PANEL - 'tf'i l 'rd.(' . l l' t { a ,,E . 1 r d t _ -.. 1 T ' t ;. ? y 1 • ZO t �� L i . f B { / �, y s f -1 y` xs ` t. • t i { r ' v ( ` ( k i gip, •� Y i f <d 4, :''' 4 4 :fi r s , ' 3 '' t'.- -' P. . f' .�:v 1 ' ^. � ._. • .•w'`. .. ,. I • r areas protected by levees from 100 I F1/ .. f — x year flood. • w 't p v OTHER AREAS ` : r r • ZONE X Areas determined to be outside 500 4 t t } t year flood plain, p y. s� ZONE D Areas in whim flood hazards are 4 , 0 > ,,, i undetermined. • d ' yam f L ? /j/1 al' 40 Flood Bou nd a ry • ,� #'S,'t a - 7 _ — — Floodwa Boundar j {4 rt ill f - 'k � • � I • { ' // .4••• - Zone D Boundary I • Bound Dividing S ' t 4 x zr. ♦ 1 ' / — � Boundary B Pecial Flood a , i Hazard Zones, and Boundary .h y >r ; ( Dividing Areas of Different Coastal Base Flood Elevations +i M - ") t • ♦ Within Special Flood Hazard • r !` l , 0 Zones. • { €' kz ' l ♦ Base Flood Elevation Line; Ele- • 513 vation in Feet• a t t` 1 P RM1O3 ♦ O O Cross Section Line • ` :'� t z �; f ♦y lEL 9871 Base Flood Elevation in Fen c r7 f '"� t r • Where Uniform WiNin Zone• , � R M 7 X Elevation R eference Mark I 6 3 p- i i ♦ ♦♦ , • MI .S ` ♦ r River Mi i f ♦ HM28 Highway Mile I " a t } x ...+�+.� - ♦ / •Referenced to the National Geodetic Vertical Datum of 1929 i tit, P w <, � ♦ N OTES wt i f y-il r - ♦ / . This ma is for use m administering the NaLOnal F lood In,wan.e r -� "* B" r 3 • - -^ ` y a" „ t r Program; it does not necessarily identify all areas subten to Hooding 7Vw� a, i ' t particularly from local drainage sources d small size, or all .; vl+- i.,N ,/v ` . ejEl O■ I planimetric features outside Special Flood Hazard Areas. 3 `,,:: AR ` 1 r`.. � • / e" ' / Certain areas not in Special Flood Hazard Areas may be protected ^" y + ' _ m et" 1� ; J•, by flood control structures res y p I f1 ' m a n , 1, r C �` ;. 9 f ♦ g Boundaries of the floodways were computed at cross sections and I k - � interpolated between cross sections. The floodways were based on Il j _ ',SW/ k _ , k 5 s hydraulic considerations with regard to requirements of the Federal �- Emergency Management Agency ` . r r , °n / 5 x i' Floodway widths in / some areas may be too narrow to show to scale tI i - - �,.. 4e '/ m Refer to Floodway Data Table where oodway width is shown at i • _J i 1120 inch. q.i = R i "'f T ; ! Coastal base flood elevations apply only landward of the shoreline --i•-.i' couttr Elevation reference marks are described in the Flood Insurance Study / ZONE X Report • t �� a . _ ¢ � y, •� Corporate limits shown are current as of the date ot this map Thy user should contact appropriate community officials to determine ' 2ND court . if corporate limits have changed subsequent to the issuance ot this . � 1 ■• • _ ma ii 1111 ` For c ommunity panel revision history prior to countywide mapping *—#'F,1:<'''-'i.'.. . ■■ 3 RD see section 6.0 of the Flood Insurance Study Report coum For adloimng panels, see separately printed Map Index l TT. ZONE X - MAP REPOSITORY 1 „y, Y I - Refer to Repository Listing on Map Index 1 r r ti' >,0,.. i ± • - ' i l S' HM1O1 . +�* ( EFFECTIVE DATE OF COUNTYWIDE l c 4V. / - - FLOOD INSURANCE RATE MAP. vy OCTOBER 17, 1989 4 �` ZONE X .�! "� • E FFECTIVE DATES) OF REVISIONS TO THIS PANEL: 1 ♦ • -� t 1. `� i _ f i i 3 P o� F i IA - ej ' i i E `,, `' ' I ; ! To determine a flood insurance is available, contact an insurance /7,...,....... agent or ca ll the National Flood Insurance Program at (&X1) 63&662U # # S n j;5 � I 500 APPROXIMATE SCALE IN FEET r I a I -1 H 0 500 �,d4 r 1 I H J • 1 1 CDBG -H -9 PREAPPLICATION SURVEY SUMMARY FORM JURISIDICTION Monroe County TOTAL # OF UNITS SURVEYED 35 NUMBER OF UNITS TO BE REHABILITATED 35 DEMOLISHED 0 TOTAL # OF UNDUPLICATED DIRECT BENEFICIARIES 143 TOTAL # OF UNITS TO BE ADDRESSED THAT HAVE A HEALTH /SAFETY NEED 35 # of DCA Very Low Income # of Units Number of Persons USE Range Surveyed Units in ONLY within to .- Household Range Addressed 1 $ 0 TO $ 13,350 2 2 2 $ 0 TO $ 15,300 4 4 3 $0 TO $ 17,200 8 8 4 $0 TO $ 19,100 8 8 5 $ $ 0 TO 20,650 6 6 6 $ 0 TO $ 22,150 2 2 • 7 $ 0 TO $ 23,700 5 5 8 $ 0 TO $ 25,200 Total I 35 35 I l # of DCA Low and Moderate # of Units Number of Persons USE Income Range ! Surveyed Units in ONLY within to be Household Range Addressed 1 . $ 0 TO $ 18,200 2 $ 0 TO $ 20,800 3 $0 TO $ 23,400 4 $0 TO $ 26,000 5 $ 0 TO $ 27,650 6 $0 TO $ 29,250 7 $0 TO $ 30,900 8 $0 TO $ 32,500 Total I - - (16) CDBG -H -9 PREAPPLICATION SURVEY SUMMARY FORM SUMMARY OF UNITS TO BE ADDRESSED BY PROJECT STRUCTURAL CONDITION Good Minor Major Non - Condition Repair Repair Repair - A. Interior Needed Needed able 1. Floors 32 3 2. Ceilings __ - Z 3. Bathroom Fixtures . Walls 30 - "5' B. Exterior 1. Siding 1 .30 4 2. Foundation fig 3. Windows 4. Roofing __ C. General 1. Septic System 35 2. Electrical System '' 76- 3. Heating System N/A _ 4. Plumbing System 1 5 - Tr Totals for each column 69 170 146 0 SUMMARY OF TOTAL UNITS SURVEYED (Includes data from Summary of Units to be Addressed) STRUCTURAL CONDITION Good Minor Major Non - Condition Repair Repair Repair - A. Interior Needed Needed able • 1. Floors 2. Ceilings 3. Bathroom Fixtures 4. Walls B. Exterior 1. Siding 2. Foundation 3. Windows 4. Roofing -- C. General 1. Septic System 2. Electrical System 3. Heating System 4. Plumbing System Totals for each column (17) CDBG -H -10 OTHER JURISDICTIONAL ACTIVITIES Instructions: Complete this form only once for the application, whether a joint or an individual application. 1. Is mutual action necessary to address a common problem shared by more than one local government? (Note: Interlocal Agreement required for an answer of 'yes'.) Yes No X If yes, name the local governing bodies which will participate and identify which local government has been designated lead agency. 2. Do the activities to be conducted relate to other community development activities within the jurisdiction? Yes No X If yes, explain the relationship of the proposed activities? 3. List the category, date and amount of any CDBG grant applications which have been submitted within the last 90 days, and /or any grant application anticipated for submission within 30 days subsequent to this application. N/A 4. Is the successful completion of this project dependent upon an application or award of, or the continued funding of any grant or loan to the applicant(s) or any party with whom an Interlocal Agreement is required? •Yes No X If "Yes ", state the source, amount, terms and any ocher pertinent information which could adversely impact the timely initiation and completion of proposed activities to be . completed under this application. (18) • t CDBG -H -12 STATEMENT OF ASSURANCES 1. Title I of the Housing and Community Development Act of 1974, as amended; 2. Inform affected persons of their rights and the policies set forth in 24 CFR part 42 and 24 CFR 570.602(b). 3. Florida Small and Minority Business Act, Sections 288.702 - 288.714, F.S.; 4. Florida Coastal Zone Protection Act, Sections 161.52 - 161.58, F.S.; 5. Local Government Comprehensive Planning and Land Development Regulation Act, Part 11, Chapter 163, F.S.; 6. Davis -Bacon Act (40 U.S.C. Section 276 a -5); 7. Contract Work Hours and Safety Standards Act of 1962 (40 U.S.C. S 327 et. seq.); 8. Copeland Anti - Kickback Act of 1934 (18 U.S.C.); 9. Section 8 Existing Housing Quality Standards, 24 C.F.R. Part 882. 10. Federal Fair Labor Standards Act (29 U.S.C. Section 201 et. seq.); 11. Title VI of the Civil Rights Act of 1964, as amended (P.L. 88 -352) and 24 C.F.R. Part I as amended; 12. Title VIII of the Civil Rights Act of 1968, as amended (P.L. 90 -284) and Executive Order 12259; 13. Age Discrimination Act of 1975; 14. Executive Order 12259 - Leadership and Coordination of Fair Housing; 15. Section 109 of the Housing and Community Development Act of 1974, (the "Act "), as amended, 24 C.F.R. 570 , 601 and Executive Order 11063; 16. Section 504 of the Rehabilitation Act of 1973; 17. Executive Order 11246 as amended by Executive Order 11375 and 12086, 24 C.F.R. Part 130 and 41 C.F.R. Chapter 60; 18. Section 3 of the Housing and Urban Development Act of 1968 - as amended Employment /Training of Lower Income Residents and Local Business Contracting; 19. Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970, as amended, (URA) P.L. 100 -17 and 24 CFR Part 42; 20. Single Audit Act of 1984; 21. Section 401(f) of the Lead -Based Paint Poisoning Prevention Act, as amended (42 U.S.C. Section 483 1(b) et. seq.; 22. National Environmental Policy Act of 1969, (42 U.S.C. Section 432 et. seq.) and 24 C.F.R., Part 58.; (21) CDBG -H -12 STATEMENT OF ASSURANCES 23. Section 319, (P.L. 101 -121) "Government Wide Guidance for New Restrictions on Lobbying; Interim Final Guidance "; 24. National Historic Preservation Act of 1966 (16 U.S.C. Section 470); 25. Preservation of Archaeological and Historical Data Act of 1966 (16 U.S.0 Section 469(9)1. et. seq.); 26. Flood Disaster Protection Act of 1973, (P. L. 93 -234, 87 Section 975); 27. Executive Order 11593 - Protection and Enhancement of Cultural Environment; 28. Reservoir Salvage Act; 29. Safe Drinking Water Act of 1974, as amended (42 U.S.0 Section 300 et. seq.); 30. Endangered Species Act of 1973, as amended (16 U.S.C. Section 1531 et. seq.); 31. Executive Order 11988 - Floodplain Management; 32. The Federal Water Pollution Control Act of 1972, as amended (33 U.S.C., Section 1251 et. seq.); 33. Executive Order 11990 - Protection of Wetlands; 33. Wild and Scenic Rivers Act of 1968, as amended (16 U.S.C. Section 1271 et. seq.); 34. Clean Air Act of 1970, as amended (42 U.S.C. Section 7401 et. seq.); 35. The Solid Waste Disposal Act, as amended by the Resource Conservation and Recovery Act of 1975 (42 U.S.C., Section 6901 et. seq.); 36. HUD Environmental Standards (24 C.F.R. Part 58); 37. Farmland Protection Policy Act of 1981; 38. The Clean Water Act of 1977 (P.L. 95 -217); 39. The Fish and Wildlife Coordination Act of 1958, as amended (16 U.S.C. Section 661 et seq.); 40. Noise Abatement and Control: Departmental Policy Implementation Responsibilities, and Standards, 24 CFR Part 51, Subpart B; 41. Flood Disaster Protection Act of 1973 (P.L. 92 -234); 42. Protection of Historic and Cultural Properties under HUD Programs, 24 C.F.R. Part 59; 43. Coastal Zone Management Act of 1972 (P.L. 92 -583); 44. Architectural and Construction Standards; 45. Architectural Barriers Act of 1968 (42 U.S.C. 4151); 46. Executive Order 11296, relating to evaluation of flood hazards; • (22) or CDBG -H -12 STATEMENT OF ASSURANCES 47. Executive Order 11288, relating w the prevention, control and abatement of water pollution; 48. Cost- Effective Energy Conservation Standards, 24 C.F.R. Part 39; 49. Coastal Barrier Resources Act of 1982; 50. Hatch Act; 51. OMB Circulars A -87, A -102, A -110, A -122 as amended; 52. Treasury Circular 1075 regarding drawdown of CDBG funds; The applicant hereby assures and certifies that it will comply with the abate list of applicable federal and state requirements in the administration of Its Florida Small Cities Community Der • lopment Block Grant Program: d ,/ 4 /, 17/ -2 1'/" . 6 qtr ture Tit e Date •beci-ote - G,N4, I \ )k) Witness Tit Dat IF JOINT APPLICATION: Signature Title Date Signature Title Date Witness Title Date Failure to submit signed assurances will result in a 50 point score reduction. (23) CDBG -H -13 STATEMENT OF APPLICATION Application is hereby made for a Community Development Block Grant under Title I of the Housing and Community Development Act of 1974, as amended, Section 290.046, Florida Statutes, Chapter 9B -43, Florida Administrative Code. I, the undersigned authorized representative of the applicant, certify that to the best of my knowledge and belief, the data which is incorporated in this application is true and correct; submission of the application has been duly authorized by resolution of the governing body; and, the applicant will comply with the assurances listed above. If other than the chief elected official, a copy of the official authori tion resoluti n is attached as page • if 06 Signature / itle Date Witness Title D e IF JOINT APPLICATION: Signature Title Date Signature Title Date Witness Title Date AN APPLICATION MUST BE SIGNED PRIOR TO SUBMISSION IN ORDER TO BE ELIGIBLE FOR SCORING. (24) Attached is a copy of the format used in conducting surveys of thirty -five (35) homes in the Upper and Middle Keys areas. * +'`, • CDBC -H -9 PREAPPLICATION SURVEY FORM JURISIDICTION Monroe County )176 441.11‘01,/ NAME OF OCCUPANT if ADDRESS jl, ,(� �°�y,�,�� �- t a �U� 0 DATE OF SURVEY //-A5 90 HOUSEHOLD COMPOSITION (number of persons residing in the unit) HOUSEHOLD INCOME RANGE # of Check Very Low Income Is the Household Persons Proper Range Income within the in Range • Secti 0 n 8 Proper Range? Household 0 $0 TO $ 13,350. Yes 1/ No 2 $0 TO $ 15,300. Yes No 3 $0 TO $ 17,200. Yes No • 4 $0 TO $ 19,100. Yes No 5 $0 TO $ 20,650. Yes No 6 $0 TO $ 22,150. Yes No 7 $0 TO $ 23,700. Yes No ______ j 8 $0 TO $ 25,200. Yes No # of Check Low and Moderate Is the Household Persons Proper Income Range Income within the in Range (per HUD Section 8 Proper Range? Household Income Limits) 1 $0 TO $ 18,200. Yes No 2 $0 TO $ 20,800. Yes No 3 $0 TO $ 23,400. Yes No 4 $0 TO $ 26,000. Yes No 5 $0 TO $ 27,650. Yes No 6 $0 TO $ 29,250. Yes No 7 $ 0 TO $ ,30, 900. Yes No 8 $0 TO $ 32,500. Yes No 15 i% • • CDBG -H -9 PREAPPLICATION SURVEY FORM UNIT INSPECTION EVALUATION Structural Condition Good Minor Major Non - Condition Repair Repair Repair - A. Interior Needed Needed able 1. Floors {/ 2. Ceilings 3. Bathroom Fixtures 4. Walls J- B: Exterior 1. Siding -5 ___ ___ 2. Foundation 3. Windows _Z 4. Roofing ✓ C. General 1. Septic \Sewer System .■ 2. Electrical System I/ 3. Heating System 4. Plumbing System _� (Including Water Heater) Totals for each column _L __L_ Score: Number of Minor Repair Conditions 1 X 1 = 7 Number of Major Repair Conditions 3 X 2 = Number of Nonrepairable Conditions X 3 = • Total Score /3 If score is equal to or greater than 26, than the unit should not be Rehabilitated. If you disagree with this assessment, please state the reason. RESULTS OF SURVEY: Rehab Demolition HEALTH & SAFETY SURVEY: Would the health and safety of the resident(s) of this housing unit be improved as a direct result of proposed activities (To answer yes, two of the structural conditions listed above must be in the "need of major repair" or the "non - repairable" category)? Yes 1/ No CERTIFICATION: I certify that the information stated in this form is true and accurately reflects the household composition and income data as presented to me by the occupant. 1 further certify to the structural condition of the identified unit as indicated. • INTERVIEWER: 0/A6141.) L741.64/.../.64,1 • DATE: il — IS -- 940 1004u OF THE UNITS PROPOSED TO BE ADDRESSED MUST BE SURVEYED. 16 CDI3C -H -9 ?REAPPLICATION SURVEY FORM JURISIDICTION Monroe County laAitikelt/ NAME OF OCCUPANT pw,,,,gq,�, fitetb JL- PHONE ADDRESS oZa,,d k,eu,as. .o. DATE OF SURVEY /1- /6 HOUSEHOLD COMPOSITION cZ. (number of persons residing in the unit) HOUSEHOLD INCOME RANGE # of Check Very Low Income Is the Household i Persons Proper Range Income within the in Range (per HUD Section 8 Proper Range? Household Income Limits) 1 $0 TO $ 13,350. Yes No © $0 TO $ 15,300. Yes No 3 $0 TO $ 17,200. Yes No • 4 $0 TO $ 19,100. Yes No 5 $0 TO $ 20,650. Yes No 6 $0 TO $ 22,150. Yes No 7 $0 TO $ 23,700. Yes No 8 $0 TO $ 25,200. Yes No # of Check Low • . . •. Is the Household Persons Proper Income Range Income within the in Range .(per HUD Section 8 Proper Range? Household Income Limits) 1 $0 TO $ 18,200. Yes No 2 $0 TO $ 20,800. Yes No 3 $0 TO $ 23,400. Yes No — 4 $0 TO $ 26,000. Yes No I 5 $0 TO $ 27,650. Yes No 6 $0 TO $ 29,250. Yes No 7 $0 TO $ ,30,900. Yes No — 8 $0 TO $ 32,500. Yes No — 15 • CDBG -H -9 PREAPPLICATION SURVEY FORM UNIT INSPECTION EVALUATION Structural Condition Good Minor Major Non - Condition Repair Repair Repair - A. Interior Needed Needed able 1. Floors ✓ 2. Ceilings 3. Bathroom Fixtures ✓ 4. Walls ✓ B: Exterior 1. Siding 2. Foundation / 3. Windows 4. Roofing ✓ C. General 1. Septic \Sewer System ✓ • 2. Electrical System ✓ 3. Heating System __�l� 4. Plumbing System T (Including Water Heater) Totals for each column Score: / Number of Minor Repair Conditions 4 x 1 = tv Number of Major Repair Conditions X 2 = S Number of Nonrepairable Conditions X 3 = ''// Total Score J 7�' If score is equal to or greater than 26, than the unit should not be Rehabilitated. If you disagree with this assessment, please state the reason. RESULTS OF SURVEY: Rehab ✓ Demolition HEALTH & SAFETY SURVEY: Would the health and safety of the resident(s) of this housing unit be improved as a direct result of proposed activities (To answer yes, two of the structural conditio listed above must be in the "need of major repair" or the "non - repairable" category)? Yes ✓ No CERTIFICATION: I certify that the information stated in this form is true and accurately reflects the household composition and income data as presented to me by the occupant. I further certify to the structural condition of the identified unit as indicated. INTERVIEWER: O• 17t611.14.b.C;L DATE: 1/- / 4- '9 0 100% OF THE UNITS PROPOSED TO BE ADDRESSED MUST BE SURVEYED. 16 CDBC -H -9 ?REAPPLICATION SURVEY FORM JURISDICTION Monroe County NAME OF OCCUPANT A$g_ 42_, &(#1,4 PHONE ADDRESS 4/1.4(4.4 J��.,2it DATE OF SURVEY it 5 0 HOUSEHOLD COMPOSITION Z. (number of persons residing in the unit) HOUSEHOLD INCOME RANGE # of Check the Household Persons Proper in Very Low Income Range Income within the Range • - Proper Range? Househol Limits) 1 $0 TO $ 13,350. Yes No — 2'') $0 TO $ 15,300. Yes i,. No 3 $0 TO $ 17,200. Yes No 4 $0 TO $ 19,100. Yes No 5 $0 TO $ 20,650. Yes No — 6 $0 TO $ 22,150. Yes No 7 $0 TO $ 23,700. Yes No _ j 8 $0 TO $ 25,200. Yes No # of Check Low and •. Is the Household Persons Proper in Income Range . Income within the Range •- Proper Range? Household • _ Limits) 1 $0 TO $ 18,200. Yes No — 2 $ 0 TO $ 20,800. Yes No 3 $0 TO $ 23,400. Yes No 4 $0 TO $ 26,000. Yes No 5 $0 TO $ 27,650. Yes No 6 $0 TO $ 29,250. Yes No — 7 $ 0 TO $ X 30, 900. Yes No - 8 $0 TO $ 32,500. Yes 110 15 I. , • • CDBG -H -9 ?REAPPLICATION SURVEY FORM UNIT INSPECTION EVALUATION Structural Condition Good Minor Major Non - Condition Repair Repair Repair - A. Interior Needed Needed able 1. Floors 1 / 2. Ceilings _ e ' 3. Bathroom Fixtures -1Z 4. Walls B: Exterior 1. Siding 2. Foundation — 3. Windows _� 4. Roofing 7:7 C. General 1. Septic \Sewer System 2. Electrical System 3. Heating System 4. Plumbing System (Including Water Heater) Totals for each column Z s' Score: Number of Minor Repair Conditions 6' x 1 = Number of Major Repair Conditions X 2 = 1 Number of Nonrepairable Conditions X 3 = Total Score if score is equal to or greater than 26, than the unit should not be Rehabilitated. if you disagree with this assessment, please state the reason. RESULTS OF SURVEY: Rehab t/ Demolition HEALTH & SAFETY SURVEY: Would the health and safety of the resident(s) of this housing unit be improved as a direct result of proposed activities (To answer yes, two of the structural conditio,i listed above must be in the "need of major repair" or the "non - repairable" category)? Yes No CERTIFICATION: I certify that the information stated in this form is true and accurately reflects the household composition and income data as presented to me by the occupant. 1 further certify to the structural condition of the identified unit as indicated. INTERVIEWER: j1ta4) DATE: /�� /.S Ye) 1004 OF THE UNITS PROPOSED TO BE ADDRESSED MUST BE SURVEYED. 16 A CDAC -I - 1 -9 PREAPPLICATION SURVEY FORM J URISIDICTION Monroe County I - P. NAME OF OCCUPANT PHONE �: ADDRESS a DATE OF SURVEY ///6 – 7 0 HOUSEHOLD COMPOSITION 2-- (number of persons residing in the unit) HOUSEHOLD INCOME RANGE # of Check Very Low Income Is the Household Persons Proper Range Income within the in Range • Section 8 Proper Range? Household J i 1 $0 TO $ 13,350. Yes No (..) $0 TO $ 15,300. Yes 1/ No 3 $0 TO $ 17,200. Yes No 4 $0 TO $ 19,100. Yes No 5 $0 TO $ 20,650. Yes No — 6 $0 TO $ 22,150. Yes No — 7 $0 TO $ 23,700. Yes No 8 $0 TO $ 25,200. Yes No # of Check Low and Moderate Is the Household Persons Proper Income Range Income within the in Range •- r HUD Section 8 Proper Range? Household Income 1 $0 TO $ 18,200. Yes No 2 $0 TO $ 20,800. Yes No 3 $0 TO $ 23,400. Yes No 4 SO TO $ 26,000. Yes No 5 $0 TO $ 27,650. Yes No 6 $0 TO $ 29,250. Yes No 7 $0 TO $ ,30,900. Yes No 8 $0 TO $ 32,500. Yes No — 15 r � r • CDBG -H -9 PREAPPLICATION SURVEY FORNI UNIT INSPECTION EVALUATION Structural Condition Good Minor Major Non — Condition Repair Repair Repair — A. Interior Needed Needed able 1. Floors I/ 2. Ceilings 3. Bathroom Fixtures _Le 4. Walls B: Exterior 1. Siding z./ 2. Foundation a/ 3. Windows 4. Roofing C. General 1. Septic \Sewer System ✓ 2. Electrical System ✓ 3. Heating System 4. Plumbing System tom• (Including Water Heater) Totals for each column Score: Number of Minor Repair Conditions s x 1 = 3- Number of Major Repair Conditions X 2 = S Number of Nonrepairable Conditions X 3 = Total Score /3 If score is equal to or greater than 26, than the unit should not be Rehabilitated. If you disagree with this assessment, please state the reason. RESULTS OF SURVEY: Rehab Demolition HEALTH & SAFETY SURVEY: Would the health and safety of the resident(s) of this housing unit be improved as a direct result of proposed activities (To answer yes, two of the structural conditions listed above must be in the "need of major repair" or the 'non - repairable" category)? Yes No CERTIFICATION: I certify that the information stated in this form is true and accurately reflects the household composition and income data as presented to me by the occupant. 1 further certify to the structural condition of the identified unit as indicated. INTERVIEWER: JV. DATE: //-/6 -90 100% OF THE UNITS PROPOSED TO BE ADDRESSED MUST BE SURVEYED. 16 . .. i CDBC -H -9 PREAPPLICATION SURVEY FORM JURISIDICTION Monroe County — i • /' NAME OF OCCUPANT /2) . PHONE ADDRESS . .(. DATE OF SURVEY // - /7-90 HOUSEHOLD COMPOSITION 3 (number of' persons residing in the unit) HOUSEHOLD INCOME RANGE # of Check Very Low Income Is the Household Persons Proper Range Income within the in Range (per HUD Section 8 Proper Range? Household Income Limits) 1 $0 TO $ 13,350. Yes No i 2 $0 TO $ 15,300. Yes No 0 $0 TO $ 17,200. Yes ✓ No 4 $0 TO $ 19,100. Yes No 5 _ $0 TO $ 20,650. Yes No — 6 $0 TO $ 22,150. Yes No — 7 $0 TO $ 23,700. Yes No 8 $0 TO $ 25,200. Yes No # of Check Low and Moderate Is the Household Persons Proper Income Range Income within the in Range (per HUD Section 8 Proper Range? Household Income Limits) 1 $0 TO $ 18,200. Yes No 2 $0 TO $ 20,800. Yes No 3 $0 TO $ 23,400. Yes No — 4 $ 0 TO $ 26,000. Yes No 5 $0 TO $ 27,650. Yes No 6 $0 TO $ 29,250. Yes No — 7 $0 TO $ ,30,900. Yes No — 8 $0 TO $ 32,500. Yes No 15 4 - w CDBG -H -9 PREAPPLICATION SURVEY FORM UNIT INSPECTION EVALUATION Structural Condition Good Minor Major Non - Condition Repair Repair Repair- A. Interior Needed Needed able 1. Floors ✓ 2. Ceilings ✓ { 3. Bathroom Fixtures 4. Walls B: Exterior 1. Siding ✓ ! 2. Foundation 3. Windows ✓' 4. Roofing ✓ C. General / 4 1. Septic \Sewer System V 1 2. Electrical System 3. Heating System 4. Plumbing System (Including Water Heater) Totals for each column 'L . 3 Score: � Number of Minor Repair Conditions X 1 Number of Major Repair Conditions 3 X 2 Number of Nonrepairable Conditions X 3 = Total Score /2•■ if score is equal to or greater than 26, than the unit should not be Rehabilitated. if you disagree with this assessment, please state the reason. ee RESULTS OF SURVEY: Rehab 1/ Demolition HEALTH & SAFETY SURVEY: Would the health and safety of the resident(s) of this housing unit be improved as a direct result of proposed activities (To answer yes, two of the structural conditions listed above must be in the "need of major repair" or the "non- repairable" category)? Yes ✓ No CERTIFICATION: I certify that the information stated in this form is true and accurately reflects the household composition and income data as presented to me by the occupant. 1 further certify to the structural condition of the identified unit as indicated. • INTERVIEWER: 4/t 4d to L. • DATE: //- I7— 90 100% OF THE UNITS PROPOSED TO BE ADDRESSED MUST BE SURVEYED. 16 2 ' CDBC -H -9 PREAPPLICATION SURVEY FORM JURISIDICTION Monroe County ,. r • NAME OF OCCUPANT j zta/te_... /4 1d4.t PHONE ADDRESS F t t.e.. DATE OF SURVEY //-/7 - 70 HOUSEHOLD COMPOSITION 3 (number of persons residing in the unit) HOUSEHOLD INCOME RANGE # of Check Very Low Income Is the Household Persons Proper Range Income within the in Range (per HUD Section 8 Proper Range? Household Income Limits) 1 $0 TO $ 13,350. Yes No 2 $0 TO $ 15,300. Yes No 0 $0 TO $ 17,200. Yes _ No 4 $0 TO $ 19,100. Yes No 5 $0 TO $ 20,650. Yes No 6 $0 TO $ 22,150. Yes No 7 $0 TO $ 23,700. Yes No 8 $0 TO $ 25,200. Yes No # of Check Low and Moderate Is the Household Persons Proper Income Range Income within the in Range (per HUD Section 8 Proper Range? Household Income Limits) 1 $0 TO $ 18,200. Yes No 2 $0 TO $ 20,800. Yes No 3 $0 TO $ 23,400. Yes No — 4 $0 TO $ 26,000. Yes No 5 $0 TO $ 27,650. Yes No 6 $0 TO $ 29,250. Yes No 7 $0 TO $ .30,900. Yes No 8 $0 TO $ 32,500. Yes No 15 * - , • CDBG -H -9 PREAPPLICATION SURVEY FORM UNIT INSPECTION EVALUATION Structural Condition Good Minor Major Non - Condition Repair Repair Repair - A. Interior Needed Needed able 1. Floors L / 2. Ceilings -iZ 3. Bathroom Fixtures ....... 4. Walls _� B: Exterior 1. Siding ,/ 2. Foundation 3. Windows _� 4. Roofing c/ C. General 1. Septic \Sewer System yr 2. Electrical System 3. Heating System 4. Plumbing System ✓ (Including Water Heater) Totals for each column _L_ / Score: Number of Minor Repair Conditions / X 1 = / O Number of Major Repair Conditions 0 X 2 = /w Number of Nonrepairable Conditions X 3 = Total Score /7 If score is equal to or greater than 26, than the unit should not be Rehabilitated. If you disagree with this assessment, please state the reason. RESULTS OF SURVEY: Rehab c.../ Demolition HEALTH & SAFETY SURVEY: Would the health and safety of the resident(s) of this housing unit be improved as a direct result of proposed activities (To answer yes, two of the structural condit�o s listed above must be in the "need of major repair" or the "non - repairable" category)? Yes V No CERTIFICATION: I certify that the information stated in this form is true and accurately reflects the household composition and income data as presented to me by the occupant. 1 further certify to the structural condition of the identified unit as indicated. INTERVIEWER: . ∎. DATE: //-- /7-90 100% OF THE UNITS PROPOSED TO BE ADDRESSED MUST BE SURVEYED. 16 i M , CDBC -H -9 ?REAPPLICATION SURVEY FORM JUR1SIDJCTION Monroe County �. NAME OF OCCUPANT G(_J _ W1441.4.4....• PHONE ADDRESS 06 44_4. DATE OF SURVEY //-A - 9O HOUSEHOLD COMPOSITION 3 (number of persons residing in the unit) HOUSEHOLD INCOME RANGE # of Check Very Low Income Is the Household Persons Proper Range Income within the Household Range Proper Range? Income Limits) 1 $0 TO $ 13,350. Yes No 2 $0 TO $ 15,300. yes No © $0 TO $ 17,200. Yes L" No 4 $0 TO $ 19,100. Yes No 5 $0 TO $ 20,650. Yes No 6 $O TO $ 22,150. Yes No — 7 $0 TO $ 23,700. Yes No 8 $0 TO $ 25,200. Yes No # of Check Low - • Moderate Is the Household Persons Proper Income Range Income within the in Range Proper Range? Household Income Limits) 1 $0 TO $ 18,200. Yes No 2 $0 TO $ 20,800. Yes No 3 $0 TO $ 23,400. Yes No 4 $0 TO $ 26,000. Yes No 5 $0 TO $ 27,650. Yes No 6 $0 TO $ 29,250. Yes No 7 $0 TO $ ,30,900. Yes No 8 $ 0 TO $ 32,500. Yes No — 15 CDBG -H -9 PREAPPLICATION SURVEY FORM UNIT INSPECTION EVALUATION Structural Condition Good Minor Major Non - Condition Repair Repair Repair- A. Interior Needed Needed able 1. Floors t/ 2. Ceilings 3. Bathroom Fixtures 4. Walls ✓ B: Exterior 1. Siding 2. Foundation _� 3. Windows 4. Roofing C. General 1. Septic \Sewer System ✓ 2. Electrical System 3. Heating System 4. Plumbing System � • (Including Water Heater) Totals for each column Score: Number of Minor Repair Conditions - X 1 = Number of Major Repair Conditions - X 2 = /0 Number of Nonrepairable Conditions X 3 = Total Score /,‘ If score is equal to or greater than 26, than the unit should not be Rehabilitated. If you disagree with this assessment, please state the reason. RESULTS OF SURVEY: Rehab ' Demolition HEALTH & SAFETY SURVEY: Would the health and safety of the resident(s) of this housing unit be improved as a direct result of proposed activities (To answer yes, two of the structural conditions jisted above must be in the "need of major repair" or the "non - repairable" category)? Yes No CERTIFICATION: I certify that the information stated in this form is true and accurately reflects the household composition and income data as presented to me by the occupant. 1 further certify to the structural condition of' the identified unit as indicated. INTERVIEWER: 13_ issia&oko DATE: 11--n, - QQ 100% OF THE UNITS PROPOSED TO BE ADDRESSED MUST 13E SURVEYED. 16 • • .:, CDBC -H -9 PREAPPL1CATION SURVEY FORM .URISIDICTION Monroe County yeLit NAME OF OCCUPANT �� .� an m PHONE * ST ADDRESS D s,ft.,7, DATE OF SURVEY I / - 15 - 90 HOUSEHOLD COMPOSITION 3 (number of persons residing in the unit) HOUSEHOLD INCOME RANGE # of Check Very Low Income Is the Household Persons Proper Range Income within the in Range (per HUD Section 8 Proper Range? Household Income Limits) J 1 $0 TO $ 13,350. Yes No ' 1 2 $0 TO $ 15,300. Yes No $0 TO $ 17,200. Yes — No • 4 $0 TO $ 19,100. Yes No 5 $0 TO $ 20,650. Yes No — 6 $0 TO $ 22,150. Yes No — 7 $0 TO $ 23,700. Yes No 8 $0 TO $ 25,200. Yes No it of Check Is the Household Persons Proper __________ Income within the in Range • Section 8 Proper Range? Household Income , 1 $0 TO $ 18,200. Yes No 2 $0 TO $ 20,800. Yes No 3 $0 TO $ 23,400. Yes No I — — 4 $0 TO $ 26,000. Yes No 5 $0 TO $ 27,650. Yes No 6 $ 0 TO $ 29,250. Yes No — j 7 $0 TO $ 30,900. Yes No 8 $0 TO $ 32,500. Yes No 15 CDBG -H -9 PREAPPLICATION SURVEY FORM UNIT INSPECTION EVALUATION Structural Condition Good Minor Major Non — Condition Repair Repair Repair — A. Interior Needed Needed able 1. Floors ✓ 2. Ceilings 3. Bathroom Fixtures 4. Walls B: Exterior 1. Siding 2. Foundation .7% 3. Windows 4. Roofing C. General 1. Septic \Sewer System 2. Electrical System 3. Heating System "7.r 4. Plumbing System (Including Water Heater) Totals for each column _AL Z Score: Number of Minor Repair Conditions :5' X 1 = 5 Number of Major Repair Conditions Z X 2 = Number of Nonrepairable Conditions X 3 = Total Score if score is equal to or greater than 26, than the unit should not be Rehabilitated. If you disagree with this assessment, please state the reason. RESULTS OF SURVEY: Rehab Demolition HEALTH & SAFETY SURVEY: Would the health and safety of the resident(s) of this housing unit be improved as a direct result of proposed activities (To answer yes, two of the structural conditions 'sted above must be in the "need of major repair" or the "non - repairable" category)? Yes No CERTIFICATION: I certify that the information stated in this form is true and accurately reflects the household composition and income data as presented to me by the occupant. 1 further certify to the structural condition of the identified unit as indicated. INTERVIEWER: Z. p / 4 ,41 r,GC... , DATE: /1.--/ S 90 100% OF THE UNITS PROPOSED TO BE ADDRESSED MUST BE SURVEYED. 16 CDBC -I -9 PREAPPLICATION SURVEY FORM JURISIDICTION Monroe County NAME OF OCCUPANT 9494 PHONE -* ADDRESS W.T v- a out-O,cLi DATE OF SURVEY / / /5 HOUSEHOLD COMPOSITION 3 (number of persons residing in the unit) HOUSEHOLD INCOME RANGE # of Check Very Low Income Is the Household Persons Proper Range Income within the in Range (per HUD Section 8 Proper Range? Household Income Limits) 1 $0 TO $ 13,350. Yes No r l 2 $0 TO $ 15,300. Yes No l./ $0 TO $ 17,200. Yes ✓ No 4 $0 TO $ 19,100. Yes No 5 $0 TO $ 20,650. Yes No — 6 $0 TO $ 22,150. Yes No — 7 $0 TO $ 23,700. Yes No 8 $0 TO $ 25,200. Yes No It of Check Low and Moderate Is the Household Persons Proper Income Range Income within the in Range (per HUD Section 8 Proper Range? Household Income Limits) 1 $0 TO $ 18,200. Yes No - -- 2 $0 TO $ 20,800. Yes No 3 $0 TO $ Yes 23,400. No 4 $ 0 TO $ 26,000. Yes No 5 $ 0 TO $ 27,650. Yes No 6 $ 0 TO $ 29,250. Yes No 7 $0 TO $ ,30,900. Yes No 8 $0 TO $ 32,500. Yes No 15 1 - , 1 CDBG -H -9 PREAPPLICATION SURVEY FORM UNIT INSPECTION EVALUATION Structural Condition Good Minor Major Non - Condition Repair Repair Repair - A. Interior Needed Needed able 1. Floors I/ 2. Ceilings s/ 3. Bathroom Fixtures _� 4. Walls _Z B: Exterior 1. Siding s / 2. Foundation _le! 3. Windows _� 4. Roofing ,./ C. General 1. Septic \Sewer System ✓ 2. Electrical System _ 3. Heating System 4. Plumbing System _ (Including Water Heater) Totals for each column Score: Number of Minor Repair Conditions 4 x 1 = 4. Number of Major Repair Conditions .3 X 2 = 6' Number of Nonrepairable Conditions X 3 = • Total Score /2 if score is equal to or greater than 26, than the unit should not be Rehabilitated. If you disagree with this assessment, please state the reason. RESULTS OF SURVEY: Rehab ✓ Demolition HEALTH & SAFETY SURVEY: Would the health and safety of the resident(s) of this housing unit be improved as a direct result of proposed activities (To answer yes, two of the structural conditiops listed above must be in the "need of major repair" or the "non - repairable" category)? Yes 17 No CERTIFICATION: I certify that the information stated in this form is true and accurately reflects the household composition and income data as presented to me by the occupant. 1 further certify to the structural condition of the identified unit as indicated. • INTERVIEWER: 4Q afmd f DATE: / /- /5 90 100% OF THE UNITS PROPOSED TO BE ADDRESSED MUST BE SURVEYED. 16 ,. CD13C -H -9 PREAPPLICATION SURVEY FORM JURISIDICTION Monroe County N NAME OF OCCUPANT 4.7 PRONE ADDRESS oKQ, ... DATE OF SURVEY //-/6-90 HOUSEHOLD COMPOSITION 3 (number of persons residing in the unit) HOUSEHOLD INCOME RANGE # of Check Vary Low Income Is the Household Persons Proper Range Income within the in Range (per HUD Section 8 Proper Range? Household Income Limits) 1 $0 TO $ 13,350. Yes No I 2 $0 TO $ 15,300. Yes No $0 TO $ 17,200. Yes /• No 4 $0 TO $ 19,100. Yes No 5 $0 TO $ Yes No 20,650. 6 $0 TO $ Yes es No — 7 $0 TO $ 23,700. Yes No 8 $0 TO $ 25,200. Yes No # of Check Low and Moderate Is the Household Persons Proper Income Range Income within the in Range (per HUD Section 8 Proper Range? Household Income Limits) 1 $0 TO $ 18,200. Yes No 2 $0 TO $ 20,800. Yes No 3 $0 TO $ Yes 23,400. No 4 $0 TO $ 26,000. Yes No 5 $0 TO $ 27,650. Yes No 6 $0 TO $ 29,250. Yes No 7 $0 TO $ ,30,900. Yes 140 8 $0 TO $ 32,500. Yes No 15 s K t CDBG -H -9 PREAPPLICATION SURVEY FORM UNIT INSPECTION EVALUATION Structural Condition Good Minor Major Non - Condition Repair Repair Repair - A. Interior Needed Needed able 1. Floors 2. Ceilings 3. Bathroom Fixtures 4. Walls ,« B: Exterior 1. Siding 2. Foundation 3. Windows 4. Roofing v C. General 1. Septic \Sewer System y 2. Electrical System 3. Heating System 4. Plumbing System -.e!L • (Including Water Heater) Totals for each column _ Score: Number of Minor Repair Conditions X 1 = Number of Major Repair Conditions 4 X 2 = S Number of Nonrepairable Conditions X 3 = Total Score ja,, If score is equal to or greater than 26, than the unit should not be Rehabilitated. If you disagree with this assessment, please state the reason. RESULTS OF SURVEY: Rehab � Demolition HEALTH & SAFETY SURVEY: Would the health and safety of the resident(s) of this housing unit be improved as a direct result of proposed activities (To answer yes, two of the structural conditiorys listed above must be in the "need of major repair" or the "non- repairable" category)? Yes 1..7 No CERTIFICATION: I certify that the information stated in this form is true and accurately reflects the household composition and income data as presented to me by the occupant. 1 further certify to the structural condition of the identified unit as indicated. INTERVIEWER: � • �,� lc.�C,c.P�. DATE: II -/ - 90 100% OF THE UNITS PROPOSED TO BE ADDRESSED MUST BE SURVEYED. 16 c CD13C -H -9 PREAPPLICATION SURVEY FORM JURISIDICTION Monroe County -- iliezt PeLi.te. NAME OF OCCUPANT /Oa4)-tai PHONE ADDRESS pe42. Q... DATE OF SURVEY // HOUSEHOLD COMPOSITION 3 (number of persons residing in the unit) HOUSEHOLD INCOME RANGE # of Check Very Low Income Is the Household Persons Proper Range Income within the in Range (per HUD Section 8 Proper Range? Household Income Limits) -- J 1 $0 TO $ 13,350. Yes No 2 $0 TO $ 15,300. Yes No © $0 TO $ 17,200. Yes ,.r No 4 $0 TO $ 19,100. Yes No 5 $0 TO $ 20,650. Yes No — 6 $0 TO. $ 22,150. Yes No — 7 $0 TO $ 23,700. Yes No --- d 8 $0 TO $ 25,200. Yes No # of Check Low and Moderate Is the Household Persons Proper Income Range Income within the in Range (per HUD Section 8 Proper Range? Household Income Limits) 1 $0 TO $ 18,200. Yes No 2 $0 TO $ 20,800. Yes No 3 $0 TO $ 23,400. Yes No — 4 $0 TO $ 26,000. Yes No 5 $0 TO $ 27,650. Yes No 6 $0 TO $ 29,250. Yes No 7 $0 TO $ ,30,900. Yes No 8 $0 TO $ 32,500. Yes No — 15 • • CDBG -H -9 PREAPPLICATION SURVEY FORM UNIT INSPECTION EVALUATION Structural Condition Good Minor Major Non - Condition Repair Repair Repair - A. Interior Needed Needed able 1. Floors 1/ 2. Ceilings 3. Bathroom Fixtures 4. Walls B: Exterior 1. Siding 2. Foundation 3. Windows 4./ 4. Roofing C. General 1. Septic \Sewer System 2. Electrical System 3. Heating System 4. Plumbing System ->L=:" (Including Water Heater) Totals for each column 2- S Score: Number of Minor Repair Conditions S X 1 = S' Number of Major Repair Conditions 3 X 2 = 4 Number of Nonrepairable Conditions X 3 = • Total Score /1 If score is equal to or greater than 26, than the unit should not be Rehabilitated. if you disagree with this assessment, please state the reason. RESULTS OF SURVEY: Rehab t/ Demolition HEALTH & SAFETY SURVEY: Would the health and safety of the resident(s) of this housing unit be improved as a direct result of proposed activities (To answer yes, two of the structural condiuo)s listed above must be in the "need of major repair" or the "non - repairable" category)? Yes V No CERTIFICATION: I certify that the information stated in this form is true and accurately reflects the household composition and income data as presented to me by the occupant. 1 further certify to the structural condition of the identified unit as indicated. INTERVIEWER: 0 DATE: /4 — qo 100% OF THE UNITS PROPOSED TO BE ADDRESSED MUST BE SURVEYED. 16 A rt. CDBC -H -9 PREAPPLICATION SURVEY FORM JURISIDJCTION Monroe County AZ p NAME OF OCCUPANT ,� .eL PHONE yy V ADDRESS ex.a4,t•t. DATE OF SURVEY //-/6 --90 HOUSEHOLD COMPOSITION 3 (number of persons residing in the unit) HOUSEHOLD INCOME RANGE # of Check Very Low Income Is the Household Persons Proper Range Income within the in Range • Section 8 Proper Range? Household Income Limits) 1 $0 TO $ 13,350. Yes No I 2 $0 TO $ 15,300. Yes No 0 $0 TO $ 17,200. Yes ✓ No 4 $0 TO $ 19,100. Yes No 5 $0 TO $ 20,650. Yes N o — 6 $0 TO $ 22,150. Yes No — 7 $0 TO $ 23,700. Yes No 8 $0 TO $ 25,200. Yes No # of Check Low and •. Is the Household Persons Proper Income Range Income within the in Range (per HUD Section 8 Proper Range? Household Income Limits) 1 $0 TO $ 18,200. Yes No 2 $0 TO $ 20,800. Yes No 3 SO TO $ 23,400. Yes No — 4 $0 TO $ 26,000. Yes No 5 $0 TO $ 27,650. Yes No 6 $0 TO $ 29,250. Yes No 7 $0 TO $ ,30,900. Yes No 8 $0 TO $ 32,500. Yes No 15 r CDBC -H -9 • PREAPPLICATION SURVEY FORM UNIT INSPECTION EVALUATION Structural Condition Good Minor Major Non - Condition Repair Repair Repair - A. Interior Needed Needed able 1. Floors 2. Ceilings _u 3. Bathroom Fixtures 4. Walls _. B: Exterior 1. Siding y 2. Foundation JG 3. Windows ,� 4. Roofing C. General 1. Septic \Sewer System ✓ 2. Electrical System _�/ 3. Heating System 4. Plumbing System _A (Including Water Heater) Totals for each column _L Score: Number of Minor Repair Conditions t'O X 1 = Number of Major Repair Conditions i t X 2 = 7 Number of Nonrepairable Conditions X 3 = 'L Total Score l7 if score is equal to or greater than 26, than the unit should not be Rehabilitated. If you disagree with this assessment, please state the reason. RESULTS OF SURVEY: Rehab 1/ Demolition HEALTH & SAFETY SURVEY: Would the health and safety of the resident(s) of this housing unit be improved as a direct result of proposed activities (To answer yes, two of the structural conditi s listed above must be in the "need of major repair" or the "non - repairable" category)? Yes V No CERTIFICATION: 1 certify that the information stated in this form is true and accurately reflects the household composition and income data as presented to me by the occupant. 1 further certify to the structural condition of the identified unit as indicated. INTERVIEWER: aO• '/LA . DATE: // - 90 100% OF THE UNITS PROPOSED TO BE ADDRESSED MUST BE SURVEYED. 16 CDBC -H -9 PREAPPLICATION SURVEY FORM .URISIDICTION Monroe County - 3 • p NAME OF OCCUPANT jeet4did a 7 PHONE ADDRESS de DATE OF SURVEY/- /7 -90 HOUSEHOLD COMPOSITION 4Z (number of persons residing in the unit) HOUSEHOLD INCOME RANGE # of Check Very Low Income Is the Household Persons Proper Range Income within the .in Range (per HUD Section 8 Proper Range? Household Income Limits) 1 $0 TO $ 13,350. Yes No 2 $0 TO $ 15,300. Yes No 3 $0 TO $ 17,200. Yes No 0 $0 TO $ 19,100. Yes / No 5 $ TO $ Yes - 20,650. No 6 $0 TO $ 22,150. Yes No — 7 $0 TO $ 23,700. Yes No 8 $0 TO $ 25,200. Yes No # of Check Low and •. Is the Household Persons Proper in Income Range . Income within the Range •- • Proper Range? Household • - Limits) 1 $0 TO $ 18,200. Yes No 2 $0 TO $ 20,800. Yes No 3 $0 TO $ 23,400. Yes No — 4 $0 TO $ 26,000. Yes No 5 $0 TO $ 27,650. Yes No 6 $0 TO $ 29,250. Yes No 7 $0 TO $ ,30,900. Yes No 8 $0 TO $ 32,500. Yes No 15 • CDI3G -H -9 PREAPPLICATION SURVEY FORM UNIT INSPECTION EVALUATION Structural Condition Good Minor Major Non - Condition Repair Repair Repair - A. Interior Needed Needed able 1. Floors ✓ 2. Ceilings 12' 3. Bathroom Fixtures 4. Walls B: Exterior 1. Siding 2. Foundation 3. Windows _/ 4. Roofing C. General 1. Septic \Sewer System ✓ 2. Electrical System _1 3. Heating System 4. Plumbing System (Including Water Heater) Totals for each column Z Score: Number of Minor Repair Conditions ! X 1 = Number of Major Repair Conditions cc X 2 = /0 Number of Nonrepairable Conditions X 3 = Total Score If score is equal to or greater than 26, than the unit should not be Rehabilitated. If you disagree with this assessment, please state the reason. RESULTS OF SURVEY: Rehab Demolition HEALTH & SAFETY SURVEY: Would the health and safety of the resident(s) of this housing unit be improved as a direct result of proposed activities (To answer yes, two of the structural conditions isted above must be in the "need of major repair" or the "non - repairable" category)? Yes t••• No CERTIFICATION: I certify that the information stated in this form is true and accurately reflects the household composition and income data as presented to me by the occupant. 1 further certify to the structural condition of the identified unit as indicated. INTERVIEWER: .0 . 4/1.I(21A.e. ., , DATE: j1-17 • 9 0 100% OF THE UNITS PROPOSED TO 13E ADDRESSED MUST BE SURVEYED. 16 R 7 ,, CDBC -H -9 PREAPPLICATION SURVEY FORM JURISIDICTION Monroe County --Z X NAME OF OCCUPANT Idavu. PHONE iF ADDRESS DATE OF SURVEY J/ /7 HOUSEHOLD COMPOSITION 4 (number of persons residing in the unit) HOUSEHOLD INCOME RANGE it of Check Very Low Income Is the Household Persons Proper Range Income within the in Range (per HUD Section 8 Proper Range? Household Income Limits) ______ 1 $0 TO $ 13,350. Yes No 2 $0 TO $ 15,300. Yes No � • 3 $0 TO $ 17,200. Yes No (g J $0 TO $ 19,100. Yes // No 5 $0 TO $ 20,650. Yes No 6 $0 TO $ 22,150. Yes No 7 $0 TO $ 23,700. Yes No 8 $0 TO $ 25,200. Yes No 1 # of Check Low and Moderate Is the Household Persons Proper Income Range Income Within the in Range (per HUD Section 8 Proper Range? Household Income Limits) 1 $0 TO $ 18,200. Yes No 2 $0 TO $ 20,800. Yes No — 3 $0 TO $ 23,400. Yes No — — 4 $0 TO $ 26,000. Yes No 5 $0 TO $ 27,650. Yes No 6 $0 TO $ 29,250. Yes No 7 $0 TO $ .30,900. Yes No 8 $0 TO $ 32,500. Yes No 15 /- CDBG -H -9 ?REAPPLICATION SURVEY FORM UNIT INSPECTION EVALUATION Structural Condition Good Minor Major Non - Condition Repair Repair Repair - A. Interior Needed Needed able 1. Floors L 2. Ceilings 3. Bathroom Fixtures _AC/ 4. Walls B: Exterior 1. Siding ✓ 2. Foundation 3. Windows 4. Roofing C. General 1. Septic \Sewer System 2. Electrical System 3. Heating System 4. Plumbing System ✓ • (Including Water Heater) Totals for each column _ � s Score: Number of Minor Repair Conditions T X 1 = Number of Major Repair Conditions 3 X 2 = ) Number of Nonrepairable Conditions X 3 = Total Score J If score is equal to or greater than 26, than the unit should not be Rehabilitated. if you disagree with this assessment, please state the reason. RESULTS OF SURVEY: Rehab Demolition HEALTH & SAFETY SURVEY: Would the health and safety of the resident(s) of this housing unit be improved as a direct result of proposed activities (To answer yes, two of the structural conditio,1 listed above must be in the "need of major repair" or the "non- repairable" category)? Yes V No CERTIFICATION: I certify that the information stated in this form is true and accurately reflects the household composition and income data as presented to me by the occupant. 1 further certify to the structural condition of the identified unit as indicated. INTERVIEWER: £L DATE: //- /7- 90 100% OF THE UNITS PROPOSED TO BE ADDRESSED MUST BE SURVEYED. 16 , r ' ` CDRC -H -9 PREAPPLICATION SURVEY FORM JURISIDICTION Monroe County — NAME OF OCCUPANT LL' . 45khdaA4 PHONE ADDRESS Oet DATE OF SURVEY / / -/ 7-90 HOUSEHOLD COMPOSITION f (number of persons residing in the unit) HOUSEHOLD INCOME RANGE # of Check Very Low Income Is the Household Persons Proper Range Income within the in Range (per HUD Section 8 Proper Range? Household Income Limits) 1 $0 TO $ 13,350. Yes No 2 $0 TO $ 15,300. Yes No 3 $0 TO $ 17,200. Yes No 0 ' $0 TO $ 19,100. Yes L... 140 • 5 $0 TO $ 20,650. Yes No — 6 $0 TO $ 22,150. Yes No 7 $0 TO $ 23,700. Yes No 8 SO TO $ 25,200. Yes No # of Check Low and Moderate Is the Household Persons Proper Income Range Income within the in Range (per HUD Section 8 Proper Range? Household Income Limits) 1 $0 TO $ 18,200. Yes No 2 $0 TO $ 20,800. Yes No 3 $0 TO $ 23,400. Yes No — 4 $0 TO $ 26,000. Yes No 5 $0 TO $ 27,650. Yes 140 6 $ 0 TO $ 29,250. Yes No — 7 $0 TO $ ,30,900. Yes No — 8 $0 TO $ 32,500. Yes 140 15 - CDBG -H -9 PREAPPLICATION SURVEY FORM UNIT INSPECTION EVALUATION Structural Condition Good Minor Major Non - Condition Repair Repair Repair - A. Interior Needed Needed able 1. Floors 2. Ceilings 3. Bathroom Fixtures a/ 4. Walls t/ B: Exterior 1. Siding t/ 2. Foundation _Ief 3. Windows 4. Roofing _jam C. General 1. Septic \Sewer System ✓ 2. Electrical System ✓' 3. Heating System 4. Plumbing System (Including Water Heater) Totals for each column Z. Score: ,3 X 1 = Number of Minor Repair Conditions / Number of Major Repair Conditions G X 2 = /2, Number of Nonrepairable Conditions X 3 = Total Score If score is equal to or greater than 26, than the unit should not be Rehabilitated. If you disagree with this assessment, please state the reason. RESULTS OF SURVEY: Rehab Demolition HEALTH & SAFETY SURVEY: Would the health and safety of the resident(s) of this housing unit be improved as a direct result of proposed activities (To answer yes, two of the structural condition listed above must be in the "need of major repair" or the "non - repairable" category)? Yes ✓ No CERTIFICATION: I certify that the information stated in this form is true and accurately reflects the household composition and income data as presented to me by the occupant. 1 further certify to the structural condition of the identified unit as indicated. • INTERVIEWER: N . /( DATE: 1/— 17 - 90 100% OF THE UNITS PROPOSED TO BE ADDRESSED MUST BE SURVEYED. 16 CDBC -I -9 PREAPPL1CATION SURVEY FORM JURISIDJCTION Monroe County NAME OF OCCUPANT 1 I c ,o., PHONE f ADDRESS pea.t.L. DATE OF SURVEY /I -17- 16 HOUSEHOLD COMPOSITION 1 (number of persons residing in the unit) HOUSEHOLD INCOME RANGE # of Check Very Low Income Is the Household Persons Proper Range Income within the in Range (per HUD Section 8 Proper Range? Household Income Limits) J 1 $0 TO $ 13,350. Yes No I 2 i $0 TO $ 15,300. Yes No 3 $0 TO $ 17,200. Yes No 0 $0 TO $ 19,100. Yes ✓ No • 5 $0 TO $ 20,650. Yes No — 6 $0 TO $ 22,150. Yes No — 7 $0 TO $ 23,700. Yes No 8 $0 TO $ 25,200. Yes No # of Check Low and Moderate Is the Household Persons Proper Income Range Income within the in Range (per HUD Section 8 Proper Range? Household Income Limits) 1 $0 TO $ 18,200. Yes No 2 $0 TO $ 20,800. Yes No 3 $0 TO $ 23,400. Yes No — 4 $0 TO $ 26,000. Yes No 5 $0 TO $ 27,650. Yes No 6 $0 TO $ 29,250. Yes No 7 $0 TO $ ,30,900. Yes No 8 $0 TO $ 32,500. Yes No 15 . 4, r ' CDBC -H -9 PREAPPLICATION SURVEY FORN1 UNIT INSPECTION EVALUATION Structural Condition Good Minor Major Non - Condition Repair Repair Repair - A. Interior Needed Needed able 1. Floors ../ 2. Ceilings ../ 3. Bathroom Fixtures 4. Walls I./ B: Exterior 1. Siding 2. Foundation ✓ 3. Windows ✓ 4. Roofing C. General 1. Septic\Sewer System ✓ P -;7.e 2. Electrical System 3. Heating System `� 4. Plumbing System (Including Water Heater) Totals for each column Z.- 4 Score: Number of Minor Repair Conditions . X 1 = s Number of Major Repair Conditions L I X 2 = Number of Nonrepairable Conditions X 3 = Total Score _.,..13 if score is equal to or greater than 26, than the unit should not be Rehabilitated. If you disagree with this assessment, please state the reason. RESULTS OF SURVEY: Rehab v Demolition HEALTH & SAFETY SURVEY: Would the health and safety of the resident(s) of this housing unit be improved as a direct result of proposed activities (To answer yes, two of the structural conditions listed above must be in the "need of major repair" or the "non - repairable" category)? Yes !f No CERTIFICATION: I certify that the information stated in this form is true and accurately reflects the household composition and income data as presented to me by the occupant. 1 further certify to the structural condition of the identified unit as indicated. INTERVIEWER: CD• DATE: `1— 11 ! 9 100% OF THE UNITS PROPOSED TO BE ADDRESSED MUST BE SURVEYED. 16 t CDBC -H -9 PREAPPLICATION SURVEY FORM JURISIDICTION Monroe County - ),7 4,i,4ti Z.41%-> NAME OF OCCUPANT -II / et. PHONE ADDRESS O` d'tGGs42-d -#' ' DATE OF SURVEY J/- /S HOUSEHOLD COMPOSITION 1 (number of persons residing in the unit) HOUSEHOLD INCOME RANGE # of Check Very Low Income Is the Household Persons Proper Range Income within the in Range (per HUD Section 8 Proper Range? Household Income Limits) 1 $0 TO $ 13,350. Yes No 2 $0 TO $ 15,300. Yes No 1 3 $0 TO $ 17,200. Yes No 4 $0 TO $ 19,100. Yes y No 5 $0 TO $ 20,650. Yes No — 6 $0 TO $ 22,150. Yes No — 7 $0 TO $ 23,700. Yes No 8 $0 TO $ 25,200. Yes No # of Check Low and Moderate Is the Household Persons Proper Income Range Income within the in Range (per HUD Section 8 Proper Range? Household Income Limits) 1 $0 TO $ 18,200. Yes No 2 $0 TO $ 20,800. Yes No 3 $0 TO $ 23,400. Yes No — 4 $0 TO $ 26,000. Yes No 5 $0 TO $ 27,650. Yes No 6 $0 TO $ 29,250. Yes No 7 $0 TO $ ,30,900. Yes No 8 $0 TO $ 32,500. Yes No 15 . T ' CDBC -H -9 PREAPPLICATION SURVEY FORM UNIT INSPECTION EVALUATION Structural Condition Good Minor Major Non - Condition Repair Repair Repair - A. Interior Needed Needed able 1. Floors 2. Ceilings 3. Bathroom Fixtures .....-/ 4. Walls e./ B: Exterior 1. Siding 2. Foundation _.;.7- / 3. Windows ✓ 4. Roofing C. General / 1. Septic \Sewer System 2. Electrical System ...--' 3. Heating System 4. Plumbing System — (Including Water Heater) Totals for each column 2 T ,...6.. Score: ,,11 ' L L Number of Minor Repair Conditions , L X 1 = Number of Major Repair Conditions "3 X 2 = ) b Number of Nonrepairable Conditions X 3 = . Total Score /4 If score is equal to or greater than 26, than the unit should not be Rehabilitated. If you disagree with this assessment, please state the reason. RESULTS OF SURVEY: Rehab • Demolition HEALTH & SAFETY SURVEY: Would the health and safety of the resident(s) of this housing unit be im roved as a direct result of proposed activities (To answer yes, two of the structural condit' s listed above must be in the "need of major repair" or the "non - repairable" category)? Yes No CERTIFICATION: I certify that the information stated in this form is true and accurately reflects the household composition and income data as presented to me by the occupant. 1 further certify to the structural condition of the identified unit as indicated. INTERVIEWER: 0- . DATE: 1l- ) 5. -. 9 100% OF THE UNITS PROPOSED TO BE ADDRESSED MUST BE SURVEYED. 16 4 • r CD13C -H -9 PREAPPLICATION SURVEY FORM JURISIDICTION Monroe County 127a/14,77 NAME OF OCCUPANT N''• PHONE ADDRESS aCC �D�/L¢�� DATE OF SURVEY /A15 HOUSEHOLD COMPOSITION 'f' (number of persons residing in the unit) HOUSEHOLD INCOME RANGE # of Check Very Low Income Is the Household Persons Proper Range Income within the in Range (per HUD Section 8 Proper Range? Household Income Limits) 1 $0 TO $ 13,350. Yes No 2 $0 TO $ 15,300. Yes No 1 3 $0 TO $ 17,200. Yes No 0 $0 TO $ 19,100. Yes L/ No 5 $0 TO $ 20,650. Yes No — 6 $0 TO $ 22,150. Yes No — 7 $0 TO $ 23,700. Yes No 8 $0 TO $ 25,200. Yes No it of Check Low and Moderate Is the Household Persons Proper Income Range Income within the in Range (per HUD Section 8 Proper Range? Household Income Limits) . , 3. $0 TO $ 18,200. Yes No 2 $0 TO $ 20,800. Yes No 3 $0 TO $ 23,400. Yes No — 4 $0 TO $ 26,000. Yes No 5 $ 0 TO $ 27,650. Yes No 6 $0 TO $ 29,250. Yes No 7 $0 TO $ • 30,900. Yes No 8 $0 TO $ 32,500. Yes No 15 r • • CDBG -H -9 PREAPPLICATION SURVEY FORM UNIT INSPECTION EVALUATION Structural Condition Good Minor Major Non - Condition Repair Repair Repair - A. Interior Needed Needed able 1. Floors 2. Ceilings J/ 3. Bathroom Fixtures ✓ 4. Walls B: Exterior 1. Siding 2. Foundation ./ 3. Windows A./ 4. Roofing A/ C. General 1. Septic \Sewer System 2. Electrical System .,i 3. Heating System 4. Plumbing System ! .. — (Including Water Heater) Totals for each column _ __ 1 Score: Number of Minor Repair Conditions (/ X 1 = to Number of Major Repair Conditions 4 X 2 = r Number of Nonrepairable Conditions X 3 = Total Score If score is equal to or greater than 26, than the unit should not be Rehabilitated. If you disagree with this assessment, please state the reason. RESULTS OF SURVEY: Rehab ✓ Demolition HEALTH & SAFETY SURVEY: Would the health and safety of the resident(s) of this housing unit be improved as a direct result of proposed activities (To answer yes, two of the structural condi[igrfs listed above must be in the "need of major repair" or the "non - repairable" category)? Yes ✓✓ No CERTIFICATION: I certify that the information stated in this form is true and accurately reflects the household composition and income data as presented to me by the occupant. 1 further certify to the structural condition of the identified unit as indicated. INTERVIEWER: Q LiAd,(J4c4 ...J DATE: 1/- /s' / 0 100% OF THE UNITS PROPOSED TO BE ADDRESSED MUST BE SURVEYED. 16 ' CDIIC -H -9 ?REAPPLICATION SURVEY FORM JURISIDICTION Monroe County / V . NAME OF OCCUPANT R� PHONE ADDRESS 04444.. DATE OF SURVEY n--/6 - 90 HOUSEHOLD COMPOSITION (number of persons residing in the unit) HOUSEHOLD INCOME RANGE # of Check Very Low Income Is the Household Persons Proper Range Income within the in Range (per HUD Section 8 Proper Range? Household Income Limits) 1 $0 TO $ 13,350. Yes No 2 $0 TO $ 15,300. Yes No 3 $0 TO $ 17,200. Yes No 0 $0 TO $ 19,100. Yes t/ No 5 $0 TO $ 20,650. Yes No 6 $0 TO $ 22,150. Yes No — 7 $0 TO $ 23,700. Yes No 8 $0 TO $ 25,200. Yes No • # of Check Low and Moderate Is the Household Persons Proper Income Range Income within the in Range (per HUD Section 8 Proper Range? Household Income Limits) 1 $0 TO $ 18,200. Yes No 2 $ 0 TO $ 20,K0. Yes No` 3 $0 TO $ 23,400. Yes No — 4 $0 TO $ 26,000. Yes No 5 $0 TO $ 27,650. Yes No 6 $ 0 TO $ 29,250. Yes No — 7 $0 TO $ ,30,900. Yes No 8 $0 TO $ 32,500. Yes No 15 A• a r • CDBG -H -9 PREAPPLICATION SURVEY FORM UNIT INSPECTION EVALUATION Structural Condition Good Minor Major Non — Condition Repair Repair Repair — A. Interior Needed Needed able 1. Floors y 2. Ceilings _ 3. Bathroom Fixtures 4. Walls _ B: Exterior 1. Siding • 2. Foundation _ 3. Windows v 4. Roofing C. General 1. Septic \Sewer System 2. Electrical System 4 .,/' 3. Heating System 4. Plumbing System (Including Water Heater) Totals for each column 2i fa_ 3 Score: Number of Minor Repair Conditions t X 1 = 6, Number of Major Repair Conditions 3 X 2 = G Number of Nonrepairable Conditions X 3 = • Total Score /2 If score is equal to or greater than 26, than the unit should not be Rehabilitated. If you disagree with this assessment, please state the reason. RESULTS OF SURVEY: Rehab Demolition HEALTH & SAFETY SURVEY: Would the health and safety of the resident(s) of this housing unit be improved as a direct result of proposed activities (To answer yes, two of the structural condition listed above must be in the "need of major repair" or the "non- repairable" category)? Yes No CERTIFICATION: I certify that the information stated in this form is true and accurately reflects the household composition and income data as presented to me by the occupant. 1 further certify to the structural condition of the identified unit as indicated. INTERVIEWER: , � �'�L�i �� �6 p � . Q7 � � - 1 . DATE: " liZ) 100% OF THE UNITS PROPOSED TO BE ADDRESSED MUST BE SURVEYED. 16 r CDBC -H -9 PREAPPLICATION SURVEY FORM JURJSIDICTION Monroe County 4Z i A NAME OF OCCUPANT . 5 PHONE �: ADDRESS OC 4 e., DATE OF SURVEY // -fib - 96 HOUSEHOLD COMPOSITION 1 / (number of persons residing in the unit) HOUSEHOLD INCOME RANGE # of Check Very Low Income Is the Household Persons Proper Range Income within the in Range (per HUD Section 8 Proper Range? Household Income Limits) 1 $0 TO $ 13,350. Yes No _ 2 $0 TO $ 15,300. Yes No 3 $0 TO $ 17,200. Yes No 0 $0 TO $ 19,100. Yes 1/ No • 5 $0 TO $ 20,650. Yes No — 6 $0 TO $ 22,150. Yes No 7 $0 TO $ 23,700. Yes No 8 $0 TO $ 25,200. Yes No # of Check Is the Household Persons Proper ________ Income within the in Range (per HUD Section 8 Proper Range? Household Income Limits) 1 $0 TO $ 18,200. Yes No 2 $0 TO $ 20,800. Yes No 3 $0 TO $ 23,400. Yes No — 4 $0 TO $ 26,000. Yes No 5 $0 TO $ 27,650. Yes No 6 $0 TO $ 29,250. Yes No — 7 $0 TO $ .30,900. Yes No — 8 $O TO $ 32,500. Yes No — 15 I .✓ • I CDBG -H -9 PREAPPLICATION SURVEY FORM UNIT INSPECTION EVALUATION Structural Condition Good Minor Major Non - Condition Repair Repair Repair - A. Interior Needed Needed able 1. Floors t/ 2. Ceilings c/ 3. Bathroom Fixtures y 4. Walls y B: Exterior 1. Siding (/ 2. Foundation ./ 3. Windows -se 4. Roofing _� C. General 1. Septic \Sewer System c/ 2. Electrical System �/ 3. Heating System 4. Plumbing System ./ (Including Water Heater) / Totals for each column ___1_ . Score: _ s Number of Minor Repair Conditions 3 X 1 = Number of Major Repair Conditions .) X 2 = �d Number of Nonrepairable Conditions X 3 = Total Score /S if score is equal to or greater than 26, than the unit should not be Rehabilitated. if you disagree with this assessment, please state the reason. RESULTS OF SURVEY: Rehab ✓ Demolition HEALTH & SAFETY SURVEY: Would the health and safety of the resident(s) of this housing unit be improved as a direct result of proposed activities (To answer yes, two of the structural conditio�r listed above must be in the "need of major repair" or the "non - repairable" category)? Yes ✓ No CERTIFICATION: I certify that the information stated in this form is true and accurately reflects the household composition and income data as presented to me by the occupant. 1 further certify to the structural condition of the identified unit as indicated. n INTERVIEWER: JO . ` DATE: 11-- /b - 9 I00% OF THE UNITS PROPOSED TO BE ADDRESSED MUST BE SURVEYED. 16 CDBC -H -9 PREAPPLICATION SURVEY FORM JURISIDICTION Monroe County NAME OF OCCUPANT 4 PHONE ADDRESS p 01, DATE OF SURVEY li-- c � qa HOUSEHOLD COMPOSITION S (number of persons residing in the unit) HOUSEHOLD INCOME RANGE # of Check Very Low Incomes Is the Household Persons Proper Range Incomes within the in Range (per HUD Section 8 Proper Range? Household Income Limits) 1 $0 TO $ 13,350. Yes No 2 $0 TO $ 15,300. Yes No 3 $0 TO $ 17,200. Yes No 4 $0 TO $ 19,100. Yes No di" $O TO $ 20,650. Yes No 6 $0 TO $ Yes 22,150. No 7 $ TO $ 23,700. Yes No 8 $0 TO $ 25,200. Yes No # of Check Low and Moderate Is the Household Persons Proper in Income Range Income within the Range (per HUD Section 8 Proper Range? Household Income Limits) 1 $0 TO $ 18,200. Yes No 2 $ 0 TO $ 20,800. Yes No 3 $0 TO $ Yes 23,400. No 4 $0 TO $ 26,000. Yes No 5 $ 0 TO $ 27,650. Yes No 6 $0 TO $ 29,250. Yes No 7 $ 0 TO $ ,30, 900. Yes No 8 $ 0 TO $ 32,500. Yes No 15 • CDBG -H -9 PREAPPLICATION SURVEY FORM UNIT INSPECTION EVALUATION Structural Condition Good Minor Major Non- Condition Repair Repair Repair - A. Interior Needed Needed able 1. Floors 2. Ceilings —J-2 40 3. Bathroom Fixtures 4. Walls B: Exterior 1. Siding 2. Foundation _� 3. Windows -� 4. Roofing C. General 1. Septic \Sewer System ✓ 2. Electrical System • ✓ 3. Heating System 4. Plumbing System (Including Water Heater) Totals for each column _A- 4 Score: Number of Minor Repair Conditions T X 1 = Number of Major Repair Conditions 6 X 2 = w Number of Nonrepairable Conditions X 3 = Total Score f if score is equal to or greater than 26, than the unit should not be Rehabilitated. if you disagree with this assessment, please state the reason. RESULTS OF SURVEY: Rehab ✓ Demolition HEALTH & SAFETY SURVEY: Would the health and safety of the resident(s) of this housing unit be improved as a direct result of proposed activities (To answer yes, two of the structural conditio s listed above must be in the "need of major repair" or the "non - repairable" category)? Yes No CERTIFICATION: I certify that the information stated in this form is true and accurately reflects the household composition and income data as presented to me by the occupant. 1 further certify to the structural condition of the identified unit as indicated. INTERVIEWER: )0 DATE: M/• 90 100% OF THE UNITS PROPOSED TO BE ADDRESSED MUST BE SURVEYED. 16 .. I }- CDBC -H -9 PREAPPLJCATION SURVEY FORM JURISIDICTION Monroe County J P• NAME OF OCCUPANT gee PI - LONE f: ADDRESS vCQ ∎ DATE OF SURVEY // -/6 - 9'0 HOUSEHOLD COMPOSITION ,S (number of persons residing in the unit) HOUSEHOLD INCOME RANGE # of Check Very Low Income Is the Household Persons Proper Range Income within the in Range • Section 8 Proper Range? Household Income Limits) — 1 $0 TO $ 13,350. Yes No + 2 $0 TO $ 15,300. Yes No 3 $0 TO $ 17,200. Yes No 4 $0 TO $ 19,100. Yes No t..0 TO $ 20,650. Yes L...-• No — 6 $0 TO $ 22,150. Yes No — 7 $0 TO $ 23,700. Yes No $ $0 TO $ 25,200. Yes No # of Check Low and Moderate Is the Household Persons Proper Income Range Income within the in Range (per HUD Section 8 Proper Range? Household Income Limits) 1 $0 TO $ 18,200. Yes No 2 $0 TO $ 20,800. Yes No 3 $0 TO $ 23,400. Yes No — — 4 $0 TO $ 26,000. Yes No 5 $0 TO $ 27,650. Yes No 6 $0 TO $ 29,250. Yes No 7 $0 TO $ ,30,900. Yes No 8 $0 TO $ 32,500. Yes No 15 f .V • CDBG -H -9 PREAPPLICATION SURVEY FORM UNIT INSPECTION EVALUATION Structural Condition Good Minor Major Non - Condition Repair Repair Repair - A. Interior Needed Needed able 1. Floors r / 2. Ceilings -Aef 3. Bathroom Fixtures 4. Walls &/ B: Exterior 1. Siding ✓ 2. Foundation L / 3. Windows 4. Roofing _Age' C. General 1. Septic \Sewer System t/ 2. Electrical System f 3. Heating System 4. Plumbing System (Including Water Heater) Totals for each column Z Score: _ Number of Minor Repair Conditions X 1 = S Number of Major Repair Conditions / X 2 = Number of Nonrepairable Conditions X 3 = Total Score �•3 if score is equal to or greater than 26, than the unit should not be Rehabilitated. if you disagree with this assessment, please state the reason. RESULTS OF SURVEY: Rehab Demolition HEALTH & SAFETY SURVEY: Would the health and safety of the resident(s) of this housing unit be improved as a direct result of proposed activities (To answer yes, two of the structural conditions / fisted above must be in the "need of major repair" or the "non - repairable" category)? Yes V No CERTIFICATION: I certify that the information stated in this form is true and accurately reflects the household composition and income data as presented to me by the occupant. 1 further certify to the structural condition of the identified unit as indicated. INTERVIEWER: L. DATE: /1 / b - 90 100% OF THE UNITS PROPOSED TO 13E ADDRESSED MUST 13E SURVEYED. 16 CDBC -H -9 PREAPPLICATION SURVEY FORM J URISLDICT10N Monroe County d NAME OF OCCUPANT a C..ekcli PHONE ADDRESS j�j�Gi(,4Ca4a, seCtnu¢. DATE OF SURVEY //-16 HOUSEHOLD COMPOSITION S (number of persons residing in the unit) HOUSEHOLD INCOME RANGE # of Check the Household Persons Proper in Very Low Income ____________ Incomes within the Range • Proper Range? Household 3. $0 TO $ 13,350. Yes No I 2 $0 TO $ 15,300. Yes No 3 $0 TO $ 17,200. Yes No 4 $ 0 TO $ 19,100. Yes / No 0 $0 TO $ 20,650. 650. Yes 1-- No — 6 $0 TO $ 22,150. Yes No — 7 $0 TO $ 23,700. Yes No 8 $0 TO $ 25,200. Yes No __-- J ______ # of Check Low and Moderate Is the Household Persons Proper Income Range Income within the in Range (per HUD Sect ion 8 Proper Range? Household Income , 3. $0 TO $ 18,200. Yes No 2 $0 TO $ 20,800. Yes No 3 $0 TO $ 23,400. Yes No 4 $0 TO $ 26,000. Yes No — 5 $0 TO $ 27,650. Yes No 6 $0 TO $ 29,250. Yes No 7 $0 TO $ ,30,900. Yes No 8 $0 TO $ 32,500. Yes No 15 r! � • CDBC -H -9 ?REAPPLICATION SURVEY FORM UNIT INSPECTION EVALUATION Structural Condition Good Minor Major Non - Condition Repair Repair Repair - A. Interior Needed Needed able 1. Floors ✓ 2. Ceilings 3. Bathroom Fixtures 4. Walls B: Exterior 1. Siding ✓ 2. Foundation 212 3. Windows ./ 4. Roofing C. General 1. Septic\Sewer System ✓' 2. Electrical System ✓ 3. Heating System 4. Plumbing System ✓ (Including Water Heater) Totals for each column Z Score: Number of Minor Repair Conditions 5 X 1 = S Number of Major Repair Conditions y X 2 = Number of Nonrepairable Conditions X 3 = Total Score /3 If score is equal to or greater than 26, than the unit should not be Rehabilitated. If you disagree with this assessment, please state the reason. RESULTS OF SURVEY: Rehab t/ Demolition HEALTH & SAFETY SURVEY: Would the health and safety of the resident(s) of this housing unit be i roved as a direct result of proposed activities (To answer yes, two of the structural condi i s listed above must be in the "need of major repair" or the "non - repairable" category)? Yes No CERTIFICATION: I certify that the information stated in this form is true and accurately reflects the household composition and income data as presented to me by the occupant. 1 further certify to the structural condition of the identified unit as indicated. INTERVIEWER: 0 . Q DATE: 1/-1` - 9 0 100% OF THE UNITS PROPOSED TO 13E ADDRESSED MUST 13E SURVEYED. 16 CD13C -H -9 PREAPPLICATION SURVEY FORM JURISIDICTION Monroe County —11.1P. NAME OF OCCUPANT a -t.^-0 PHONE ADDRESS ,24'.:L Pe ` DATE OF SURVEY // /7- 90 HOUSEHOLD COMPOSITION (number of persons residing in the unit) HOUSEHOLD INCOME RANGE # of Check Very Low Income Is the Household Persons Proper Range Income within the in Range • Section 8 Proper Range? Household Income Limits) 1 $0 TO $ 13,350. Yes No _ [ 2 $0 TO $ 15,300. Yes No 3 $0 TO $ 17,200. Yes No 4 $0 TO $ 19,100. Yes No V $0 TO $ 20,650. Yes i� No 6 $0 TO $ 22,150. Yes No 7 $0 TO $ 23,700. Yes No 8 $0 TO $ 25,200. Yes No # of Check Low and Moderate Is the Household Persons Proper Income Range Income within the in Range (per HUD Section 8 Proper Range? Household Income Limits) 1 $0 TO $ 18,200. Yes No 2 $0 TO $ 20,800. Yes No 3 $0 TO $ 23,400. Yes No 4 $0 TO $ 26,000. Yes No 5 $0 TO $ 27,650. Yes No 6 $0 TO $ 29,250. Yes No 7 $0 TO $ .30,900. Yes No 8 $0 TO $ 32,500. Yes No 15 • CDBG -H -9 PREAPPLICATION SURVEY FORM UNIT INSPECTION EVALUATION Structural Condition Good Minor Major Non - Condition Repair Repair Repair - A. Interior Needed Needed able 1. Floors ✓ 2. Ceilings 3. Bathroom Fixtures ✓ 4. Walls _✓ B: Exterior 1. Siding 1./ 2. Foundation _ / _ 3. Windows _;? 4. Roofing _� C. General 1. Septic \Sewer System ✓ 2. Electrical System _�/ 3. Heating System 4. Plumbing System �� (Including Water Heater) Totals for each column Z. to Score: (O X 1 = li Number of Minor Repair Conditions Number of Major Repair Conditions 3 X 2 = Number of Nonrepairable Conditions X 3 = . Total Score /2. if score is equal to or greater than 26, than the unit should not be Rehabilitated. if you disagree with this assessment, please state the reason. RESULTS OF SURVEY: Rehab ✓ Demolition HEALTH & SAFETY SURVEY: Would the health and safety of the resident(s) of this housing unit be improved as a direct result of proposed activities (To answer yes, two of the structural condition listed above must be in the "need of major repair" or the "non - repairable" category)? Yes L. No CERTIFICATION: I certify that the information stated in this form is true and accurately reflects the household composition and income data as presented to me by the occupant. 1 further certify to the structural condition of the identified unit as indicated. INTERVIEWER: 0 , e f , ,Qt,.At.CL DATE: /1--- )7'9 100% OF THE UNITS PROPOSED TO BE ADDRESSED MUST 13E SURVEYED. 16 CDBC -H -9 ?REAPPLICATION SURVEY FORM JURISUDICTION Monroe County – g 70. NAME OF OCCUPANT Pl PHONE ADDRESS Q 4 ,4 DATE OF SURVEY /� /7-9'6 HOUSEHOLD COMPOSITION (number of persons residing in the unit) HOUSEHOLD INCOME RANGE # of Check Very Low Income Is the Household Persons Proper Range Income within the in Range (per HUD Section 8 Proper Range? Household Income Limits) — 1 $0 TO $ 13,350. Yes No I 2 $0 TO $ 15,300. Yes No 3 $0 TO $ 17,200. Yes No • 4 $0 TO $ 19,100. Yes No 40 $O TO $ 20,650. Yes t ' No 6 $0 TO $ 22,150. Yes No 7 $0 TO $ 23,700. Yes No 8 $0 TO $ 25,200. Yes No it of Check Low and Moderate Is the Household Persons Proper Income Range Income within the in Range (per HUD Section 8 Proper Range? Household Income Limits) 1 $0 TO $ 18,200. Yes No 2 $0 TO $ 20,800. Yes No - 3 $0 TO $ 23,400. Yes No — 4 $0 TO $ 26,000. Yes No 5 $0 TO $ 27,650. Yes No 6 $0 TO $ 29,250. Yes No 7 $0 TO $ ,30,900. Yes No 8 $0 TO $ 32,500. Yes No 15 • CDBG -H -9 PREAPPLICATION SURVEY FORM UNIT INSPECTION EVALUATION Structural Condition Good Minor Major Non — Condition Repair Repair Repair — A. Interior Needed Needed able 1. Floors ✓ 2. Ceilings 3. Bathroom Fixtures ./ 4. Walls B: Exterior 1. Siding &/ 2. Foundation 3. Windows ✓ 4. Roofing C. General 1. Septic \Sewer System 2. Electrical System 3. Heating System 4. Plumbing System (Including Water Heater) Totals for each column 2.. �p Score: Number of Minor Repair Conditions 4, x 1 = (p Number of Major Repair Conditions 3 X 2 = (p Number of Nonrepairable Conditions X 3 = Total Score If score is equal to or greater than 26, than the unit should not be Rehabilitated. if you disagree with this assessment, please state the reason. RESULTS OF SURVEY: Rehab Demolition HEALTH & SAFETY SURVEY: Would the health and safety of the resident(s) of this housing unit be improved as a direct result of proposed activities (To answer yes, two of the structural conditions sled above must be in the "need of major repair" or the "non - repairable" category)? Yes No CERTIFICATION: I certify that the information stated in this form is true and accurately reflects the household composition and income data as presented to me by the occupant. 1 further certify to the structural condition of the identified unit as indicated. INTERVIEWER: L . DATE: / /7 100% OF THE UNITS PROPOSED TO BE ADDRESSED MUST BE SURVEYED. 16 CDBC -H -9 PREAPPLICATION SURVEY FORM JURISIDICTION Monroe County iv NAME OF OCCUPANT ad. lay. - rItds+tt a' PHONE ADDRESS %ai�Qi DATE OF SURVEY 1/Lib '` HOUSEHOLD COMPOSITION S (number of persons residing in the unit) HOUSEHOLD INCOME RANGE # of Check Very Low Income Is the Household Persons Proper Range Income within the in Range (per HUD Section 8 Proper Range? Household Income Limits) 1 $0 TO $ 13,350. Yes No 2 $0 TO $ 15,300. Yes No 3 $0 TO $ 17,200. Yes No 4 $0 TO $ 19,100. Yes No 40 $0 TO $ 20,650. Yes /7 No 6 $0 TO $ 22,150. Yes No 7 $0 TO $ 23,700. Yes No 8 $0 TO $ 25,200. Yes No # of Check Low and Moderate Is the Household Persons Proper Income Range Income within the in Range (per HUD Section 8 Proper Range? Household Income Limits) 1 $0 TO $ 18,200. Yes No 2 $0 TO $ 20,800. Yes No 3 $0 TO $ 23,400. Yes No — 4 $0 TO $ 26,000. Yes No 5 $0 TO $ 27,650. Yes No 6 $0 TO $ 29,250. Yes No 7 $0 TO $ ,30,900. Yes No 8 $0 TO $ 32,500. Yes No 15 0 • CDBG -H -9 PREAPPLICATION SURVEY FORM UNIT INSPECTION EVALUATION Structural Condition Good Minor Major Non - Condition Repair Repair Repair - A. Interior Needed Needed able 1. Floors �✓ 2. Ceilings �G 3. Bathroom Fixtures ✓ 4. Walls 1✓ B: Exterior 1. Siding 2. Foundation 3. Windows 4. Roofing c✓ C. General 1. Septic \Sewer System �✓ 2. Electrical System 3. Heating System 4. Plumbing System ✓ (Including Water Heater) Totals for each column Score: Number of Minor Repair Conditions I t X 1 = Number of Major Repair Conditions S X 2 = /0 Number of Nonrepairable Conditions X 3 Total Score �T If score is equal to or greater than 26, than the unit should not be Rehabilitated. If you disagree with this assessment, please state the reason. RESULTS OF SURVEY: Rehab "✓ Demolition HEALTH & SAFETY SURVEY: Would the health and safety of the resident(s) of this housing unit be improved as a direct result of proposed activities (To answer yes, two of the structural conditionklisted above must be in the "need of major repair" or the "non - repairable" category)? Yes ✓ No CERTIFICATION: I certify that the information stated in this form is true and accurately reflects the household composition and income data as presented to me by the occupant. 1 further certify to the structural condition of the identified unit as indicated. INTERVIEWER: L. DATE: // / -90 I00% OF THE UNITS PROPOSED TO BE ADDRESSED MUST BE SURVEYED. 16 CDBC -H -9 PREAPPLICATION SURVEY FORM JURIS[DICTION Monroe County —)./, NAME OF OCCUPANT pn, .�,// PHONE ADDRESS X=101_ DATE OF SURVEY W-/710 HOUSEHOLD COMPOSITION 49 (number of persons residing in the unit) HOUSEHOLD INCOME RANGE # of Check Very Low Income Is the Household Persons Proper Income within the in Range (per HUD Section 8 Proper Range? Household Income Limits) 1 $0 TO $ 13,350. Yes No 2 $0 TO $ 15,300. Yes No 3 $0 TO $ 17,200. ' Yes No • 4 $0 TO $ 19,100. Yes No 5 $0 TO $ 20,650. Yes NO — — $0 TO $ 22,150. Yes ✓ No 7 $0 TO $ 23,700. Yes No 8 $0 TO $ 25,200. Yes No # of Check Low and Moderate Is the Household Persons Proper Income Range Income within the in Range (per HUD Section 8 Proper Range? Household Income Limits) 1 $0 TO $ 18,200. Yes No 2 $0 TO $ 20,800. Yes No 3 $0 TO $ 23,400. Yes No 4 $0 TO $ 26,000. Yes No 5 $0 TO $ 27,650. Yes No — 6 $0 TO $ 29,250. Yes No 7 $0 TO $ ,30,900. Yes No 8 $0 TO $ 32,500. Yes No — 15 • CDBG -H -9 PREAPPLICATION SURVEY FORM UNIT INSPECTION EVALUATION Structural Condition Good Minor Major Non - Condition Repair Repair Repair - A. Interior Needed Needed able 1. Floors 2. Ceilings 3. Bathroom Fixtures ✓ 4. Walls -AZ B: Exterior 1. Siding s / 2. Foundation 3. Windows ✓ 4. Roofing • C. General 1. Septic \Sewer System ✓ 2. Electrical System 3. Heating System 4. Plumbing System .� (Including Water Heater) Totals for each column Z 17/ Score: Number of Minor Repair Conditions X 1 = Number of Major Repair Conditions X 2 = 11) Number of Nonrepairable Conditions X 3 = Total Score 1� 1f score is equal to or greater than 26, than the unit should not be Rehabilitated. If you disagree with this assessment, please state the reason. RESULTS OF SURVEY: Rehab ` Demolition HEALTH & SAFETY SURVEY: Would the health and safety of the resident(s) of this housing unit be improved as a direct result of proposed activities (To answer yes, two of the structural conditions listed above must be in the "need of major repair" or the "non - repairable" category)? Yes No CERTIFICATION: I certify that the information stated in this form is true and accurately reflects the household composition and income data as presented to me by the occupant. 1 further certify to the structural condition of the identified unit as indicated. INTERVIEWER: 0. 0.7 DATE: 11 /7-90 100% OF THE UNITS PROPOSED TO BE ADDRESSED MUST BE SURVEYED. 16 r . 4 CDBC -H -9 ?REAPPLICATION SURVEY FORM JURISIDICTION Monroe County jI. P. NAME OF OCCUPANT Z PHONE ff ADDRESS AliAdeS,t,a,, pk', t . DATE OF SURVEY // /7- ?e.) HOUSEHOLD COMPOSITION 6 (number of persons residing in the unit) HOUSEHOLD INCOME RANGE # of Check Very Low Income Is the Household Persons Proper Income within the in Range (per HUD Section 8 Proper Range? Household Income Limits) 1 $0 TO $ 13,350. Yes No 2 $0 TO $ 15,300. Yes No 3 $0 TO $ 17,200. Yes No • 4 $0 TO $ 19,100. Yes No 5 $0 TO $ 20,650. Yes No — v $ 0 TO $ Yes No 22,150. 7 $0 TO $ 23,700. Yes No 8 $0 TO $ 25,200. Yes No # of Check Low and Moderate Is the Household Persons Proper Income Range Income within the in Range (per HUD Section 8 Proper Range? Household Income Limits) 1 $0 TO $ 18,200. Yes No 2 $0 TO $ 20,800. Yes No 3 $0 TO $ 23,400. Yes No — 4 $0 TO $ 26,000. Yes No 5 $0 TO $ 27,650. Yes No 6 $0 TO $ 29,250. Yes No — 7 $0 TO $ ,30,900. Yes No 8 $0 TO $ 32,500. Yes No — 15 ,. • ,4 r • CDBG -H -9 PREAPPLICATION SURVEY FORM UNIT INSPECTION EVALUATION Structural Condition Good Minor Major Non - Condition Repair Repair Repair - A. Interior Needed Needed able 1. Floors 2. Ceilings 3. Bathroom Fixtures v 4. Walls ✓ B: Exterior 1. Siding f 2. Foundation ✓ 3. Windows .... 4. Roofing _� C. General 1. Septic \Sewer System ✓ 2. Electrical System ,,/ 3. Heating System . 4. Plumbing System _� (Including Water Heater) Totals for each column Score: Number of Minor Repair Conditions 5 x 1 = 5 Number of Major Repair Conditions L i X 2 = Number of Nonrepairable Conditions X 3 = Total Score If score is equal to or greater than 26, than the unit should not be Rehabilitated. If you disagree with this assessment, please state the reason. RESULTS OF SURVEY: Rehab ✓ Demolition HEALTH & SAFETY SURVEY: Would the health and safety of the resident(s) of this housing unit be improved as a direct result of proposed activities (To answer yes, two of the structural conditions listed above must be in the "need of major repair" or the "non - repairable" category)? Yes ✓ No CERTIFICATION: I certify that the information stated in this form is true and accurately reflects the household composition and income data as presented to me by the occupant. 1 further certify to the structural condition of the identified unit as indicated. • INTERVIEWER: 0.. DATE: H/ —) 7 - W 1009u OF THE UNITS PROPOSED TO BE ADDRESSED MUST BE SURVEYED. 16 , . . CD13C -H -9 PREAPPLICATION SURVEY FORM JURISIDICTION Monroe County - lq NAME OF OCCUPANT g ..LQ. PHONE ;: ADDRESS 44 ) ,■ DATE OF SURVEY //- /]- 9 v HOUSEHOLD COMPOSITION 7 (number of persons residing in the unit) HOUSEHOLD INCOME RANGE # of Check Very Low Income Is the Household Persons Proper Range Income within the in Range (per HUD Section 8 Proper Range? Household Income Limits) 1 $0 TO $ 13,350. Yes No 2 $0 TO $ 15,300. Yes No 3 $0 TO $ 17,200. Yes No 4 $0 TO $ 19,100. Yes No 5 $0 TO $ 20,650. Yes No 6 $0 TO $ 22,150. Yes No ___ iar $0 TO $ 23,700. Yes No --- i 8 $ 0 TO $ 25,200. Yes No # of Check Low and Moderate Is the Household Persons Proper Income Range Income within the in Range (per HUD Section 8 Proper Range? Household Income Limits) 1 $0 TO $ 18,200. Yes No 2 $0 TO $ 20,800. Yes No 3 $0 TO $ 23,400. Yes No 4 $0 TO $ 26,000. Yes No 5 $0 TO $ 27,650. Yes No 6 $0 TO $ 29,250. Yes No — 7 $0 TO $ ,30,900. Yes No — 8 $0 TO $ 32,500. Yes No 15 A CDBG -H -9 • PREAPPLICATION SURVEY FORM UNIT INSPECTION EVALUATION Structural Condition Good Minor Major Non - Condition Repair Repair Repair - A. Interior Needed Needed able 1. Floors 2. Ceilings ✓ 3. Bathroom Fixtures • 4. Walls B: Exterior 1. Siding r� 2. Foundation 3. Windows v 4. Roofing C. General 1. Septic \Sewer System ✓ 2. Electrical System _- 3. Heating System 4. Plumbing System `. (Including Water Heater) Totals for each column Score: Number of Minor Repair Conditions s X 1 = Number of Major Repair Conditions T X 2 = Number of Nonrepairable Conditions X 3 = Total Score If score is equal to or greater than 26, than the unit should not be Rehabilitated. if you disagree with this assessment, please state the reason. RESULTS OF SURVEY: Rehab &_- Demolition HEALTH & SAFETY SURVEY: Would the health and safety of the resident(s) of this housing unit be improved as a direct result of proposed activities (To answer yes, two of the structural conditions listed above must be in the "need of major repair" or the 'non - repairable" category)? Yes ✓ No CERTIFICATION: I certify that the information stated in this form is true and accurately reflects the household composition and income data as presented to me by the occupant. 1 further certify to the structural condition of the identified unit as indicated. 7� - INTERVIEWER: DATE: II -/ 7 -PO 100% OF THE UNITS PROPOSED TO BE ADDRESSED MUST BE SURVEYED. 16 r, CDBC -H -9 NREAPPL1CATION SURVEY FORM JURISIDICTION Monroe County ), . )0. NAME OF OCCUPANT 4.04,14) PHONE it- ADDRESS OraiK-Qi DATE OF SURVEY / / - /b - HOUSEHOLD COMPOSITION 7 (number of persons residing in the unit) HOUSEHOLD INCOME RANGE it of Check Very Low Income Is the Household Persons Proper Range Income within the in Range (per HUD Section 8 Proper Range? Household Income Limits) I 1 $0 TO $ 13,350. Yes No I 2 $0 TO $ 15,300. Yes No j 3 $0 TO $ 17,200. Yes No • 4 $0 TO $ 19,100. Yes No 5 $O TO $ 20,650. Yes No — 6 $0 TO $ 22,150. Yes No — -(D $0 TO $ 23,700. Yes L/ No 8 $0 TO $ 25,200. Yes No # of Check Low . • . .. Is the Household Persons Proper Income Range Income within the in Range (per HUD Section 8 Proper Range? Household Income Limits) 1 $0 TO $ 18,200. Yes No 2 $0 TO $ 20,800. Yes No 3 $0 TO $ 23,400. Yes No 4 $0 TO $ 26,000. Yes No 5 $0 TO $ 27,650. Yes No 6 $0 TO $ 29,250. Yes No 7 $0 TO $ .30,900. Yes No 8 $0 TO $ 32,500. Yes No 15 a h r - - CDBC -H -9 PREAPPLICATION SURVEY FORM UNIT INSPECTION EVALUATION Structural Condition Good Minor Major Non - Condition Repair Repair Repair - A. Interior Needed Needed able 1. Floors 4./ 2. Ceilings L / 3. Bathroom Fixtures y 4. Walls _1e- B: Exterior 1. Siding ✓ 2. Foundation _LL 3. Windows 4. Roofing i / C. General 1. Septic \Sewer System $,/. 2. Electrical System 3. Heating System 4. Plumbing System �/ (Including Water Heater) Totals for each column Z _ Score: Number of Minor Repair Conditions ( X 1 = ( Number of Major Repair Conditions 3 X 2 = 4. Number of Nonrepairable Conditions X 3 = • Total Score /Z if score is equal to or greater than 26, than the unit should not be Rehabilitated. If you disagree with this assessment, please state the reason. RESULTS OF SURVEY: Rehab `--0"" Demolition HEALTH & SAFETY SURVEY: Would the health and safety of the resident(s) of this housing unit be improved as a direct result of proposed activities (To answer yes, two of the structural conditions listed above must be in the "need of major repair" or the "non - repairable" category)? Yes ✓No CERTIFICATION: I certify that the information stated in this form is true and accurately reflects the household composition and income data as presented to me by the occupant. 1 further certify to the structural condition of the identified unit as indicated. INTERVIEWER: 0- (1 DATE: /// 6" ?is 100% OF THE UNITS PROPOSED TO BE ADDRESSED MUST BE SURVEYED. 16 1 -0-, CD11C-H-9 PREAPPLICATION SURVEY FORM JURISLDICTION Monroe County V. /". NAME OF OCCUPANT PHONE ff ADDRESS DATE OF SURVEY / / - / - ? c HOUSEHOLD COMPOSITION 7 (number of persons residing in the unit) HOUSEHOLD INCOME RANGE # of Check Very Lou Income Is the Household Persons Proper Range Income Within the in Range (per HUD Section 8 Proper Range? Household Income Limits) 1 $0 TO $ 13,350. Yes No 2 $0 TO $ 15,300. Yes No 3 $0 TO $ 17,200. Yes No 4 $0 TO $ 19,100. Yes No 5 $0 TO $ 20,650. Yes No 6 $0 TO $ Yes 22,150. No — MI $0 TO $ 23,700. Yes No 8 $ 0 TO $ 25,200. Yes No # of Check Low and .. Is the Household Persons Proper in - Range . Income Within the Range •- . Proper Range? Household • - Limits) 1 $0 TO $ 18,200. Yes No 2 $0 TO $ 20,800. Yes No 3 $0 TO $ Yes 23,400. No 4 $0 TO $ 26,000. Yes No 5 $0 TO $ 27,650. Yes No 6 $0 TO $ 29,250. Yes No 7 $0 TO $ ,30,900. Yes No 8 $0 TO $ 32,500. Yes 110 15 • • CDBG -H -9 PREAPPLICATION SURVEY FORM UNIT INSPECTION EVALUATION Structural Condition Good Minor Major Non - Condition Repair Repair Repair - A. Interior Needed Needed able 1. Floors i/ 2. Ceilings _� 3. Bathroom Fixtures —iL 4. Walls _we B: Exterior 1. Siding 1/ 2. Foundation ._ 3. Windows ✓ 4. Roofing � — C. General 1. Septic \Sewer System tom' 2. Electrical System J 3. Heating System 4. Plumbing System f (Including Water Heater) Totals for each column - . Score: Number of Minor Repair Conditions 5 X 1 = 5 ____ Number of Major Repair Conditions L X 2 = q g Number of Nonrepairable Conditions X 3 = Total Score /3 If score is equal to or greater than 26, than the unit should not be Rehabilitated. If you disagree with this assessment, please state the reason. RESULTS OF SURVEY: Rehab '— Demolition HEALTH & SAFETY SURVEY: Would the health and safety of the resident(s) of this housing unit be improved as a direct result of proposed activities (To answer yes, two of the structural condition fisted above must be in the "need of major repair" or the "non - repairable" category)? Yes L No CERTIFICATION: 1 certify that the information stated in this form is true and accurately reflects the household composition and income data as presented to me by the occupant. I further certify to the structural condition of the identified unit as indicated. INTERVIEWER: 0. O1 DATE: /1— Ho —90 100% OF THE UNITS PROPOSED TO BE ADDRESSED MUST BE SURVEYED. 16 CD13C -1 -9 PREAPPLICATION SURVEY FORM JURISIDICTION Monroe County NAME OF OCCUPANT Am#_, )444 ��// PHONE � ADDRESS W 42. et o(orccaa� DATE OF SURVEY // 90 HOUSEHOLD COMPOSITION 7 (number of persons residing in the unit) HOUSEHOLD INCOME RANGE # of Check Very Low Income Is the Household Persons Proper Range Income within the in Range (per HUD Section 8 Proper Range? Household Income Limits) - - - - - -- 1 $0 TO $ 13,350. Yes No 2 $ 0 TO $ 15,300. Yes No 3 $0 TO $ 17,200. Yes No 4 $ TO $ 19,100. Yes No 5 $0 TO $ Yes No o 20,650. es 6 $0 TO $ Yes 22,150. No 6 ) $0 TO $ 23,700. Yes ✓ No 8 $0 TO $ 25,200. Yes No # of Check Low and Moderate Is the Household Persons Proper Income Range Income within the in Range (per HUD Section 8 Proper Range? Household Income Limits) 1 00 Yes No 2 • TO $ 20,800. Yes No 3 Yes No — 4 ' TO $ 26,000. Yes No 5 • TO $ 27,650. Yes No Yes No Yes No 8 • TO $ 32,500. Yes No 15 y CDBG -H -9 PREAPPLICATION SURVEY FORM UNIT INSPECTION EVALUATION Structural Condition Good Minor Major Non — Condition Repair Repair Repair A. Interior Needed Needed able 1. Floors t/ 2. Ceilings y 3. Bathroom Fixtures 4. Walls B: Exterior 1. Siding 2. Foundation 3. Windows y 4. Roofing ✓ C. General 1. Septic \Sewer System 2. Electrical System 3. Heating System 4. Plumbing System t/ (Including Water Heater) Totals for each column _AL Score: Number of Minor Repair Conditions 6 X 1 = (p Number of Major Repair Conditions 3 X 2 Number of Nonrepairable Conditions X 3 = Total Score if score is equal to or greater than 26, than the unit should not be Rehabilitated. If you disagree with this assessment, please state the reason. RESULTS OF SURVEY: Rehab a/ Demolition HEALTH & SAFETY SURVEY: Would the health and safety of the resident(s) of this housing unit be improved as a direct result of proposed activities (To answer yes, two of the structural conditions listed above must be in the "need of major repair" or the "non- repairable" category)? Yes i/ No CERTIFICATION: I certify that the information stated in this form is true and accurately reflects the household composition and income data as presented to me by the occupant. 1 further certify to the structural condition of the identified unit as indicated. INTERVIEWER: , . DATE: 11 - JS' go 100% OF THE UNITS PROPOSED TO BE ADDRESSED MUST BE SURVEYED. 16 CDI3C -H -9 PREAPPLICATION SURVEY FORM JURISIDICTION Monroe County NAME OF OCCUPANT • 14406 PHONE ADDRESS 0&4640 DATE OF SURVEY l/ HOUSEHOLD COMPOSITION (number of persons residing in the unit) HOUSEHOLD INCOME RANGE # of Check Very Low Income Is the Household Persons Proper Range Income within the in Range (per HUD Section 8 Household Proper Range? Income Limits) 1 $ 0 TO $ 13,350• Yes No I 2 $ 0 TO $ 15,300. Yes No 3 $ 0 TO $ 17,200. Yes No 4 $ 0 TO $ 19,100. Yes No 5 $0 TO $ 20,650. Yes No 6 MI $0 TO $ MI II 22,150. Yes No $0 TO $ 23,700. Yes I/ No 8 $0 TO $ 25,200. Yes No # of Check Low and Moderate Is the Household Persons Proper Income Range Income within the in Range (per HUD Section 8 Proper Range? Household Income Limits) 1 $0 TO $ 18,200. Yes No 2 $0 TO $ 20,800. Yes No 3 $0 TO $ 23,400. Yes No 4 $0 TO $ 26,000. Yes No 5 $0 TO $ 27,650. Yes No 6 $0 TO $ 29,250. Yes No 7 $0 TO $ ,30,900. Yes No 8 $0 TO $ 32,500. Yes No 15 • CDBG-H-9 • H -9 PREAPPLICATION SURVEY FORM UNIT INSPECTION EVALUATION Structural Condition Good Minor Major Non - Condition Repair Repair Repair - A. Interior Needed Needed able 1. Floors 1/ 2. Ceilings 3. Bathroom Fixtures _iG 4. Walls ✓ B: Exterior 1. Siding 2. Foundation _ 3. Windows _� 4. Roofing _� C. General 1. Septic \Sewer System 2. Electrical System 3. Heating System _� 4. Plumbing System L (Including Water Heater) Totals for each column /Q Score: Number of Minor Repair Conditions / X 1 = / Number of Major Repair Conditions /4) X 2 = a0 Number of Nonrepairable Conditions X 3 = Total Score o1 if score is equal to or greater than 26, than the unit should not be Rehabilitated. If you disagree with this assessment, please state the reason. RESULTS OF SURVEY: Rehab Demolition HEALTH & SAFETY SURVEY: Would the health and safety of the resident(s) of this housing unit be improved as a direct result of proposed activities (To answer yes, two of the structural conditions listed above must be in the "need of major repair" or the "non - repairable" category)? Yes r/ No CERTIFICATION: I certify that the information stated in this form is true and accurately reflects the household composition and income data as presented to me by the occupant. I further certify to the structural condition of the identified unit as indicated. • INTERVIEWER: ratiiitai draelc cAs DATE: //- /6 90 100% OF THE UNITS PROPOSED TO BE ADDRESSED MUST BE SURVEYED. 16 CDBC -H -9 PREAPPLICATION SURVEY FORM JURISDICTION Monroe County I• P. NAME OF OCCUPANT • d#4 � PHONE � ADDRESS orQ,�� DATE OF SURVEY J/ 16 "990 HOUSEHOLD COMPOSITION 7, (number of persons residing in the unit) HOUSEHOLD INCOME RANGE # of Check Very Low Income Is the Household Persons Proper in Range HUD Section 8 Income within the Range (per Proper Range? I Household Income Limits) __ i 1 $0 TO $ 13,350. Yes N - — I — - - - o () $0 TO $ 15,300. Yes l/ No 3 $0 TO $ 17,200. Yes No 4 $0 TO $ 19,100. Yes No 5 $0 TO $ 20,650. Yes No — 6 $0 TO $ Yes No 22,150. — 7 $ 0 TO $ 23,700. Yes No 8 $0 TO $ 25,200. Yes No -- d _ __ ___ # of Check Low and Moderate Is the Household Persons Proper Income Range Income within the in Range (per HUD Section 8 Proper Range? Household Income Limits) 1 $0 TO $ 18,200. Yes No 2 $ 0 TO $ 20,800 . Yes No 3 $0 TO $ Yes es No 4 $ 0 TO $ 26,000. Yes No 5 $0 TO $ 27,650. Yes No 6 $0 TO $ 29,250. Yes No 7 $0 TO $ ,30,900. Yes No 8 $0 TO $ 32,500. Yes No 15 • CDBG -H -9 1 ?REAPPLICATION SURVEY FORM UNIT INSPECTION EVALUATION Structural Condition Good Minor Major Non - Condition Repair Repair Repair - A. Interior Needed Needed able 1. Floors _1/ 2. Ceilings `/ 3. Bathroom Fixtures i/ 4. Walls _= B: Exterior 1. Siding _ 2. Foundation 3. Windows 1� 4. Roofing ` i — C. General 1. Septic \Sewer System ✓ 2. Electrical System ./ 3. Heating System 4. Plumbing System c� (Including Water Heater) Totals for each column _ . 7 2. Score: Number of Minor Repair Conditions 9 X 1 = 7 Number of Major Repair Conditions 2-- X 2 = 7 Number of Nonrepairable Conditions X 3 = • Total Score )/ if score is equal to or greater than 26, than the unit should not be Rehabilitated. If you disagree with this assessment, please state the reason. RESULTS OF SURVEY: Rehab ✓ Demolition HEALTH & SAFETY SURVEY: Would the health and safety of the resident(s) of this housing unit be improved as a direct result of proposed activities (To answer yes, two of the structural condition5rlisted above must be in the "need of major repair" or the "non - repairable" category)? Yes No CERTIFICATION: I certify that the information stated in this form is true and accurately reflects the household composition and income data as presented to me by the occupant. 1 further certify to the structural condition of the identified unit as indicated. • INTERVIEWER: 0 d4.4e.4.24-•cd•- , DATE: / /L - 90 100% OF THE UNITS PROPOSED TO BE ADDRESSED MLJST BE SURVEYED. 16 ..- `4 CDBC -H -9 I'REAPPLICATION SURVEY FORM JURISDICTION Monroe County Imo• NAME OF OCCUPANT 6. J e . . 0.i Qt PHONE ADDRESS qJ A DATE OF SURVEY /A/4 - qj HOUSEHOLD COMPOSITION (number of persons residing in the unit) HOUSEHOLD INCOME RANGE # of Check Very Low Income Is the Household 1 Persons Proper Range Income within the in Range (per HUD Section 8 Proper Range? Household Income Limits) e � ) $0 TO $ 13,350. Yes No f . 2 $0 TO $ 15,300. Yes No 3 $0 TO $ 17,200. Yes No 4 $0 TO $ 19,100. Yes No 5 $0 TO $ 20,650. Yes No 6 $0 TO $ Yes No 22,150. . 7 $0 TO $ 23,700. Yes No 8 $0 TO $ 25,200. Yes No # of Check Low and Moderate Is the Household Persons Proper Income Range Income within the in Range (per HUD Section 8 Proper Range? Household Income Limits) 1 $0 TO $ 18,200. Yes No 2 $0 TO $ 20,800. Yes No 3 $0 TO $ Yes No 23,400. 4 $0 TO $ 26,000. Yes No 5 $0 TO $ 27,650. Yes No 6 $0 TO $ 29,250. Yes No 7 $0 TO $ ,30, 900. Yes No 8 $O TO $ 32,500. Yes 110 — 15 • CDBG -H -9 PREAPPLICATION SURVEY FORM UNIT INSPECTION EVALUATION Structural Condition Good Minor Major Non - Condition Repair Repair Repair - A. Interior Needed Needed able 1. Floors 2. Ceilings _� 3. Bathroom Fixtures ✓ 4. Walls B: Exterior 1. Siding 2. Foundation —2 3. Windows _� 4. Roofing C. General 1. Septic \Sewer System ✓ 2. Electrical System 3. Heating System 4. Plumbing System (Including Water Heater) Totals for each column Z Score: Number of Minor Repair Conditions 4 X 1 = 41, Number of Major Repair Conditions L. X 2 = Number of Nonrepairable Conditions X 3 = Total Score If score is equal to or greater than 26, than the unit should not be Rehabilitated. If you disagree with this assessment, please state the reason. RESULTS OF SURVEY: Rehab Demolition HEALTH & SAFETY SURVEY: Would the health and safety of the resident(s) of this housing unit be improved as a direct result of proposed activities (To answer yes, two of the structural conditions j' ted above must be in the "need of major repair" or the "non - repairable" category)? Yes ✓ No CERTIFICATION: I certify that the information stated in this form is true and accurately reflects the household composition and income data as presented to me by the occupant. 1 further certify to the structural condition of the identified unit as indicated. n • 0 INTERVIEWER: . f4,41„1c24.4:71 ' DATE: /6 - 9b 100% OF THE UNITS PROPOSED TO BE ADDRESSED MUST BE SURVEYED. 16 • • s p 3 - '� • �? " ` � am mi. a1► ..1 l - 044 '- MX 1211 Ptlrt k 011 Al 1 i" i • :, �et Cara t rtri tar r . . € , , l s� 4 t > t� I bd rvaile l4 ` 4 - . rt� artd .r aye a in ua�a t f .;' ics�{ and {asp..E: ,d _ ice, et!-at Griot *titer not E t 3 s aealvri,►aaay r t it tax the pro of adg # R _ ,k e4t 2acatie�•e 2.1.'' t° c}aal i' =r 'NI R 01 M ... T :;:it,t' _ > ti 1 : �. &"Asti r - x �. Ton drLs y " ittad Ltd hero)", :'. ` ' t } l -' - WiLaSnal. and } tow tanws,p,s �S+�iCf.t is�x 1� dsC�ra:.a ▪ rf.ot K. }k ,...;q-1:,,-.-c r pia? CiOB •. �i 1L# i7bM ai 9 4-011,44,40.,,,,:-..:,:;4- '� S } � .k §ma . ,-, J - Z4 a lit 4b k1 to rear . f lira { §D � 9. 6 'fir yr r ti p a� 1 1 terr for c (1 tx� 2 d ,� T . rra (2) terra t t�� of • I t . • :r y sr . Tins ptrt s.-- m > a+fa$�ectta to . * 6 :: _ ♦ T k � � t } F � ` M Ce►I�tlttir 9ri,12 ra�a �a� r1saR 0��� �ttltd� try ,�� , -_ te �►� � T_: 4 as* as iidtr �.j1�t9$a aitt tab :A ex- fir - ' irritti il el. ar ae� ibi -s , r lock La fSatattre aavt <cr iss7a �:a�aiymt ?� i : } u � „, r tome Krl 4:z? S S7 *t y+�s ® � }i Sae . W °� °[ $1 ` ;` k 'f� �� i ' ioxi®wsi ` ' ggg 1 t 1tNpl.k ;t . 111° :::::::: x�' > s1 a . _ a nr ;- - r,; 1. t s4Yi#X1 J } $SEO$' a ' 11 -- _ fell. : s ' ` - - it'-i.---4-71. ( 2) years. r��a € - i:. `. "Y S7§i Jobtaact,` tett. Atli '� - _- - '. - --- 'Z i. C,c�+a1 bed•A�'�t?1 e. *h Ali 6d ?+s f r i g very r �f /' ! ` ' �f -, r .. f. ,■ ; � 117- -44 yr. z y 4 , _ f S �M y � y ,� t' ,- • . A • ; . - = 41110 ■',11,i- - t_ ---. A ..4 A W- * ? . • • - 4`, ' 1 .4- • '' I N',PA _ A . • ■ • , \ " -- .'ttaa *Amhara 11: thiril. terms for t'.. 7..-l. i as followill 1. Nolen Stage-sleet vho shrll serve tor 0-ne t.) yala, - ....: _ 2 joicelbel ?Yrs , webb R3thaa11 serva for rm.:. C2: yoEra- - _ - -- Ri 1. -P .11 mirv for two c*. Imo 0 . - ,- - -. .„ - - _ 4. Orsyco Crary, shall servo fi„Ir chrat :3' P.-trib. 74 . Sadler. air man, wh o shall servo fert LLvol 0, S . tatty Ch yeas*. - • .., - ' = _ - -- ' 2. thole* ILE** ehall report pariiindt.-alty t.-iit , .i 'aio* - -- --- t Cor C quarterly of aPy set., viitt,t1'.*** that thmy 417 b., it th1c - 1 . _ . _,-_, rosark mod stiAA___ reportt a bads to ths Orant th ahol: la tz.= ;;;Iirs■ forwarded to tia uga" 4, k2i 041% f ar tra c.i,45 wa • 3, the mombeza .,A: v: aI CiEm4.44 1 r44° , ',4-0.V „ F ;1'/'12:A71: at the '10 * of tLa Cimmills,en the , Ita he first * saattha chdra.af, Nall toti.'1.4goic_47 tma• 3. ' l '"'' - : ..avemri mut the cxsaa tfacrea! ard craft ft': 1.z:A .4a1 41:4 P-., ' 6,116.t, _---=-1-',F---t -:::-------,12--7,---1,---,-, .,,.-..---=,- Pb &W hi rist 11.6 of c 4x ct tagutrisit 49 - T41" U34.**1 - '' ' t .,"_ ' j- -----•-=,-.72..7"-_;....i,--;.__=__ Florida, a:. a rogol soar** Caner, - 146, ----- - - .: Vet, 4 ; 4 14.1114.3.4.44AL . ■ ' , ' ; ''.: . ' '..) ' . - '7 L -- W,„__ . ' P . It.itble,"%.0 3 y _, Vet' ..,.,1,, , *1 • - . , -7 .• . . • it, 2 , D,APIRT Iiii icatz—v,v, CUA . „1,.., ,, ,, .,_.,_ „ ..,„_-_ .., Zr "L eeit of il" ., ' , / /-7 ' r,,.,;•44. - - - - - - ---,--- - --- - - -„ •, 1 Ati ''*.i, h ,i' -- , .. -: 1 5 ., '.11.-- ' C,,, „4 ' . •:,5. ''7.,;,. 031, Az- . --A - Tit I's . = L r 2 4 t , .1. i N140#•"*,--* "- - ' ' , - --• -='- .. . . , \- : . . Mayor John Stormont RESOLUTION NO. 146 -1990 _L_ o c v o_ A RESOLUTION OF THE BOARD OF COUNTY COMMIS - ,cr SIONERS OF MONROE COUNTY, FLORIDA, ABOLISHING THE CITIZEN'S ADVISORY TASK FORCE AND REPEAL- ING RESOLUTION NO. 404 -1984 J R1EREAS E the Board of County Commissioners, by Resolution No. 404 -1984, established a Citizen's Advisory Task Force to assist grant writers in funding for low cost housing; and WHEREAS, the Citizen's Advisory Task Force has not been active in recent years, their work having been completed and implemented; and WHEREAS, the Board of County Commissioners is desirous of maintaining an orderly establishment and function of various Boards and Committees; and WHEREAS, on January 10, 1990, the Board of County Commis- sioners determined that certain Boards and Committees whose functions and purposes were no longer currently needed, in context of their original authorization; and WHEREAS, the Board of County Commissioners is desirous of reestablishing those certain Boards and Committees, only in context of the then current need and purposes, at any time in the future; now, therefore BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, as follows: 1. That the Board of County Commissioners hereby dissolves the Citizen's Advisory Task Force, in that the work has been completed, and repeals Resolution No. 404 -1984. 2. That if in the future, such committee requires reestab- lishment, such reestablishment shall be in the then current context of need and purpose. PASSED AND ADOPTED by the Board of County Commissioners of Monroe County, Florida, at a regular meeting of said Board held on the /114 day of fo!„,,.. , A.D., 1990. BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA By Mayor/Chairman (SEAL) Attest :„Ep_147: . CC, er • 17,0 ttorncy s (Vic - • (I, -'4) 1 RESOLUTION NO. 645 - 1990 . A RESOLUTION OF THE MONROE COUNTY BOARD OF COMMISSIONERS CREATING AN CITIZEN ADVISORY TASK FORCE COMMITTEE TO PROVIDE INPUT AND SECURE CITIZEN PARTICIPATION IN THE SMALL CITIES CD a COMMUNITY DEVELOPMENT BLOCK GRANT - w -I ►,- . 1. ,FF -- WHEREAS, the purpose of the Small Cities Community ' c ' .cr._ D evelopment Block Grant is to assist local governments in arrying out effective community development activities to r- ; ::arrest and reverse community decline and restore community c_, v ; v w:itality; and -' ° ■ ° WHEREAS, one of the conditions of the grant `L application, is that the local government shall establish a citizen advisory task force composed of citizens in the jurisdiction in which the proposed project is to be implemented; and WHEREAS, the citizens advisory task force shall provide input relative to all phases of the project process; and WHEREAS, the Monroe County Board of Commissioners authorized the submission of a grant application to the Department of Community Affairs for the Florida Small Cities Community Development Block Grant by Resolution *620 -1990, November 14, 1990; now therefore, BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, THAT: 1. The advisory committee is hereby established to assist Monroe County in implementing the Small Cities Community Development Block Grant programs. The committee shall consist of five (5) individuals who shall assist Monroe County in determining areas that are considered appropriate for the expenditure of such grants. Initially, the areas known as Hibiscus Park in Key Largo and The Rock in Marathon are to be given consideration for this service. 2. The committee shall serve at the pleasure of the Commission and the Committee itself, upon the first meeting thereof, shall designate one of its members as the chairman thereof, and one of its members as the secretary of the same. • 3. The Committee shall report periodically of any recommendations that they may have in this regard and such reports as made to the Monroe County Grants Manager shall be in turn forwarded to the County Commission for its consideration. PASSED AND ADOPTED by the Board of County Commissioners of Monroe County, Florida, at a regular meeting of said Board held on the ,i'th day of December, A.D. 1990. BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA BY : -k\o- (SEAL) Att tt: DANNY L. KOLHAGE, Clerk P L. ;.. :: ` Atr.l r ( ,cg,j „(=ORD r ( Fll 3 04 RESOLUTION NO. 668 -1990 �L. A RESOLUTION OF THE BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA APPOINTING FIVE INITIAL MEMBERS TO THE CITIZENS ADVISORY TASK FORCE COMMITTEE TO PROVIDE INPUT AND SECURE CITIZEN PARTICIPATION IN THE SMALL CITIES COMMUNITY DEVELOPMENT BLOCK GRANT WHEREAS, the Monroe County Board of Commissioners created a Citizens Advisory Task Force Committee at a regularly scheduled meeting December 6, 1990; and WHEREAS, the purpose of the committee is to provide input and secure citizen participation in the Small Cities Community Development Block Grant; and WHEREAS, the initial Citizens Advisory Task Force Committee shall consist of five members representing the jurisdictions in which the proposed projects are implemented; now therefore, BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, as follows: 1. The Board of County Commissioners hereby appoints the following five (5) initial members to the Citizens Advisory Task Force Committee, whose terms shall be for two (2) consecutive years: Beverly Johnson Lawrence Johnson Dagny Johnson Grayce Carty Earl Carty Upon expiration of the initial members' terms, the individual Monroe County Commissioners shall designate their appointees. 2. The Committee shall serve at the pleasure of the Commission and the Committee itself, upon the first meeting thereof, shall designate one of its members as the chairman thereof, and one of its members as the secretary of the same. 3. The Committee shall assist Monroe County in determining areas that are considered appropriate for the expenditure of such grants. Initially, the areas known as Hibiscus Park in Key Largo and The Rock in Marathon are to be given consideration for this service. 4. The Committee shall report periodically of any recommendations that they may have in this regard and such reports as made to the Monroe County Grants Manager shall be in turn forwarded to the County Commission for its consideration. PASSED AND ADOPTED by the Board of County Commissioners of Monroe County, Florida, at a regular meeting of said Board held on the pol day of December, A.D. 1990. BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA DANNY L K OMAGE, Clerk (Seal) Attest: ," AND LEC` ' i C_ f 3y - 44 = \'Vf 3e8) • FILED EC'^ RE RESOLUTION NO. 620 -1990 0 y �� 26 MI 9 2i A RESOLUTION OF THE MONROE COUNTY BOARD OF COMMISSIONERS AUTHORIZING THE SUBMISSION J‘ iiA,Gt OF A GRANT APPLICATION TO THE DEPARTMENT p OF COMMUNITY AFFAIRS FOR A FLORIDA SMALL K GIR G' T 4 . ELp. CITIES COMMUNITY DEVELOPMENT BLOCK GRANT Wi4NROE Cpp� AND DIRECTING THE EXECUTION OF SAME BY THE PROPER COUNTY AUTHORITIES WHEREAS, the Department of Community Affairs has announced funding available under the Florida Small Cities Community Development Block Grant Program to eligible applicants; and WHEREAS, funds will be disbursed to eligible activities including housing and neighborhood revitalization, commercial revitalization, and economic development, and WHEREAS, up to $650,000.00 is available to complete eligible activities, and there is no requirement for matching funds, and WHEREAS, Monroe County desires to participate in said program,now therefore, BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, THAT: 1. The County Administrator is hereby authorized to submit an application for grant funds to the Department of Community Affairs to fund a Community Development Block Program, and to execute all application documents on behalf of the Monroe County Board of Commissioners, and that 2. This resolution shall become effective immediately upon adoption by the Commission and execution by the Presiding Officer and Clerk. PASSED AND ADOPTED by the Board of County Commissioners of Monroe County, Florida, at a regul r meeting of said Board held on the PHA day of !Y 6144m464r, A.D. 1990. BOARD OF COUNTY COMMISSIONERS OF MONR E COUNTY By (Seal) 14WOVEDA3 TJ, G►:;, Attest: LaND �� � t , urF'ICTV: . nv t • - RESOLUTION NO. 087 -1991 A RESOLUTION OFFICIALLY ADOPTING TITLE 49 OF THE CODE OF FEDERAL REGULATIONS, 49 CFR PART i 24, UNIFORM RELOCATION ASSISTANCE AND REAL PROPERTY ACQUIS.TION FOR FEDERAL AND FEDERALLY ASSISTED PROGRAMS; TITLE 24 OF THE CODE OF FEDERAL REGULATIONS, 24 CFR PART 570 AS AMENDED, COMMUNITY DEVELOPMENT BLOCK GRANTS. SAID ADOPTION TO BE INCORPORATED IN ALL COUNTY PROGRAMS AND POLICIES WHERE SUCH REGULATIONS APPLY; PROVIDING AN EFFECTIVE DATE WHEREAS, the County of Monroe has previously participated in various federal and federally assisted programs in full compliance with all applicable federal regulations presented; and WHEREAS, the County has a Tenant Assistance Policy and Procedures under the County's Rental Rehabilitation Loan Program; and WHEREAS, the County may apply and receive funding from other federe.1 and fede:al.ly assisted programs, inclusive of the Commn i :.y Development Block Program; now therefore BE IT RESOLVED BY THE MONROE COUNTY BOARD OF COMMISsioalm5 THAT: 1. The County Administrator is hereby authorized and directed to assure that the respective county departments responsible 2or been f4:id .r q incorporate the required federal re'.; iatiors with all necessary policy and procedure and be reap;. for updating same upon future official federal revisions. 2. This resoi4tion shall go into effect immediately upon its passage and adoption and authentication by the signatures of the presiding officer and clerk of the commission. PA$ m) AND ADOPTED by the Board of County Commissioners of Monroe Ccuaty. lqorlda, at a regular meeting of said Board held on the I've day of April, A.D. 1991. M_a•!or Harvey Yes Manor Pro gram London Ye s Cosrgn.issio: ters Cheal - Yes Cornissjoner Jones Yes Commissioner Stormont Yes i'OARD OF COUNTY COMMISSIONERS CF MONROE COUNTY by (Seal) DANNY I., 3COL CAGE, Clerk Attest: f ■II;;;(W AsTINTWW sllFFIcfENcX D t " J' r�,� , , d The Key West Citizen Published Daily Key West, Monroe County, Florida 33040 STATE OF FLORIDA) ss. COUNTY OF MONROE) Before the undersigned authority personally appeared Randy Erickson, who on oath says that he is...►.. Retail Manger of the Key West Citizen, a daily newspaper published at Key West in Abnroe County, Florida; that the attached copy of advertisement, being a . `�. • • .•`� In the matter of .... � . ..(1_, � �J Lx. 71(. Cj was Published in said newspaper in the issues of Affaint further says that the said The Key West Citizen is a newspaper published at Key West, in said Monroe County, Florida, and that the newspaper has heretofore been continuously published in said Dbnroe County, Florida, each day (except Sat.) and has been entered as second class mail matter at the Post Office in Key West, in said Monroe County, Florida, for a period of one year next preceeding the first publication of the attatched copy �f advertisement; anf affiant further says that he has neither paid nor promised any person, firm or corporation any discount, rebat commission or refund for the purpose of securing this advertisement for publication in the said newspaper. TE nc FLG?IDA ( 39,1 77 , 1931 I';P { F A RAL IfiS. I ND. 5D?i'3ZO INR CL4L �' (SEAL) 6(—_ /41 4 SWORN AND / c �I • - .o e me this day of • •19 -. ���;: -- �•tary .Public Commission Expires DEC 4 1990 10;). . tai - - e-- �•• .. cu wUUlu sCdy up, .,a to to keep out currencies are uncovered weekly. pUBLIf TEAMING NOTICE I S PUBLIC HEARING The County of Monroe is considering applying to the Florida Department of Community Affairs (DCA) for a Small Cities Community Development Block grant (CDBG) of up to $650,000. These funds must be used for one of the following purposes: 1. To benefit low and moderate income persons; or 2. To aid in the prevention or elimination of slums or blight; or 3. To meet other community development needs having a particular ur- gency because existing conditions pose a serious and immediate threat to the health or, welfare of the community and where other financial re- sources are not available to meet such needs. The category of activities for which these funds may be used are in the areas: • Housing and neighborhood revitalization to include such activities as housing rehabilitation, demolition of dilapidated housing and relocation of residents, weath erization and energy- efficiency improvements, code enforcement, land assembly or site preparation for new 'construction, physical improvement activities such as water and sewer improvements, street improvements, drainage and neighborhood facilities. Commercial revitalization to include such activities as rehabilitation and demolition of dilapidated buildings, relocation of residents, physical im- provement activities such as water sewer improvements, street improve - ments,drainage, and neighborhood facilities. Economic development to include such improvement activities as acqui- sition of real property, loans to private for - profit businesses, purchase of machinery and equipment, or energy conservation. Additional informa- tion regarding the range of activities that may be undertaken will be pro - vided at the public hearing. Additional information regarding the range of activities that may be un- dertaken will be provided at the public hearing. At least 60% of the funds must be used for activities which benefit low and moderate income persons. In developing an application for submission to DCA, the County of Mon - roe must plan to 'minimize displacement of persons as a result of planned CDBG activities. In addition, the County of Monroe is required to develop a plan to assist displaced persons. The public hearing to receive citizen views concerning the community's housing and community development needs will be held in Big Pine Key at St. Peter's Church on November 13, 1990, at 3:00 p.m. To obtain ad- ditional information concerning the public hearing, contact Deanna Lloyd, Public Service Building, Stock Island, 292 -4474. t. PUBLIC HEARING NOTICE 2nd PUBLIC HEARING The County of Monroe is considering applying to the Florida Department of Community Affairs (DCA) for a Small Cities Community Development Block Grant (CDBG) of up to $650,000. 1. To benefit low and moderate income persons; or 2. To aid in the prevention or elimination of slums or blight; or 3. To meet other community development needs having a particular urgency because existing conditions pose a serious and immediate threat to the health or welfare of the community and where other financial resources are not available to meet such needs. The category of activities for which these funds may be used are in the areas: Housing and neighborhood revitalization to include such activities as housing rehabilitation, demo- lition of dilapidated housing and relocation of residents, weatherization and energy- efficiency im- provements, code enforcement, land assembly or site preparation for new construction, pysical im- provement activities such as water and sewer improvements, street improvements, drainage and neighborhood facilities. Commercial revitalization to include such activities as rehabilitation and demolition of dilapidated buildings, relocation of residents, physical improvement activities such as water sewer improve- ments, street improvements, drainage, and neighborhood facilities. Economic development to include such improvement activities as acquisition of real property, loans to private for - profit businesses, purchase of machinery and equipment, or energy conservation. Additional information regarding the range of activities that may be undertaken will be provided at the public hearing. At least 60% of the funds must be used for activities which benefit low and moderate income per- sons. In developing an application for submission to DCA, the County of Monroe must plan to minimize displacement of persons as a result of planned CDBG activities. In addition, the County of Monroe is required to develop a plan to assist displaced persons. The public hearing to receive citizen views concerning the community's housing and community de- velopment needs will be held in Plantation Courtroom "A" on November 26, 1990, at 5:00 p.m. To obtain additional information concerning the public hearing, contact Deanna Lloyd, Public Secvic e Building, Stock Island, 292 -4474. +� i • L.. The Key West Citizen r Published Daily Key West, Nbnroe County, Florida 33040 • STATE OF FLORIDA) ss. COUNTY OF MDNROE) Before the undersigned authority personally appeared Randy Erickson, who on oath says that he is Retail Manger of the Key West Citizen, a daily newspaper published at Key West in Abnroe County, Florida; • yk that the attached copy of advertisement, being a .. . In the matter of .... a& 01/4-Liaia • was Published in said newspaper in the issues of Affaint further says that the said The Key West Citizen is a newspaper published at Key West, in said Nbnroe County, Florida, and that the newspaper has heretofore been continuously published in said Monroe County, Florida, each day (except Sat.) and has been entered as second class mail matter at the Post Office in Key West, in said Monroe County, Florida, for a period of one year next preceeding the first publication of the attatched copy �f advertisement; anf affiant further says that he has neither paid nor promised any person, firm or corporation any discount, rebate commission or refund for the purpose of securing this advertisement for publication in the said newspaper. _ _ _.12r,6 NOTA 2 BLIC STAif OF FLORIDA MY C ry I (N FXR"JILY 21, 1991 E. ;i 1 L is ctb -, INS. Ii 0. (SEAL) SWORN AND SUBSCRI ) 1 fore me this / . day of - - -le*,) • 19 �'�, - ' , •tary Public Commission Expires • '. \\\ 'w'd SZ :S qp pauanocpp sum buTpeew eqq 'queunuoo oTTgnd ou buTeq eaegs •gnduT oTTgnd oq uagsTT pup qupaf xooTg quauidoTanaa AgTununuoO aqq ssnosTp oq paTTpo SPM buTieem aqs •paooaa oquT buTaueq oTTgnd puZ eqq buTounouup 'aagaodag sAax aeddn '066T 'ST aaqutanoN • egg woa; uoTgeoTTgnd 3o 3ooad eqq ppea quouiaogg aeuoTsslunuoO • ssaad age ;o aequiaui paT;TquapTun 9110 pup 'saornaas quewebpuuN go aogoaaTQ AlunoO eoauoyw 'aedapg abaoeD 'aeuoTssTUnuoD AqunoO aoauow 'quowaogs ugor pepnTouT quesead asogs •aepao oq peTTpo spM buTgeeW 'W d 00 :5 saoTAaes quewebpuuN AqunoO eoauow 0661 '9Z aaqutanoN „v„ wooaganoO uoTgaqupTd DNINVH14 0I'Igfld aNZ SN'fl1E XDOal SNSNdO'ITASQ AZINf NWOO j \ V � A SMALL CITIES COMMUNITY DEVELOPMENT . d BLOCK GRANT The County of Monroe is applying to the Florida Department of Community Affairs (D.C.A.) for a grant and •r the Housing Category in the amount of $650,000 under the Flail Cities Community K Development Block Grant (C.D.B.G.) program. For each activity that is 'proposed, at least 60% of the funds must benefit low and moderate • income persons. The primary objective of this application is to improve • housing conditions and up -grade units to a safe, decent and sanitary condition for low- income citizens through housing rehabilitation of 35 STATE OF FLORIDA) units in the Hibiscus Park and Marathon area. No displacement will SS, occur. COUNTY OF hi0NR0E A copy of the application will be available for review at the Public ) Service Building, Jr. College Rd. West, Stock Island, Wing II, Office of Grants Management, on Monday through Friday between 8:30 a.m. to 5:00 p.m. Comments are encouraged and must be submitted in writing. To obtain additional information concerning the application and the public hearing, contact Deanna Lloyd at 292 -4474. Randy Eric the Key West Citizen, a daily newspaper published at Key Westin Monroe County, Florida; that the attached copy of advertisement, being a i . L .QLc In the matter of .... . L . , c_ ,b/tAxii Pj was Published in said newspaper in the issues of Affaint further says that the said The Key West Citizen is a newspaper published at Key West, in said Monroe County, Florida, and that the newspaper has heretofore been continuously published in said Monroe County, Florida, each day (except Sat.) and has been entered as second class mail matter at the Post Office in Key West, in said Monroe County, Florida, for a period of one year next preceeding the first e publication of the attatched copy of advertisement; anf affiant further says that he has neither paid nor promised any person, firm or corporation any discount, rebate commission or refund for the purpose of secur , this advertisement for publication in the said newspaper. _ NOTARY PUBLIC STATE OF FLORIDA (SEAL) NY COMMISSION EXP JULY 27,1991 ) BONDED THRU GENERAL INS. UND. l SWORN AND SUBSCR :ED ,before me this - - -- �f , . day of ; ""'� 19 t ` � `Y - �- - - Notary Public. Commission Expires • • • ,