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I. <br />A. <br />B. <br />C. <br />E. <br />II. <br />A. <br />CDBG 2013-2044 <br />APPLICATION FORM <br />DUE DATE; 5;00 .m. January 18, 2013 <br />ORGANIZATIONAL <br />Department Name: <br />Program/Project Name: <br />Mailing Address: <br />Contact Name: <br />Title: <br />Telephone: <br />Fax: <br />E-Mail: <br />Santa <br />ctor <br />SERVICE AND FUNDING <br />Identify which eligible activity is being proposed. (example <br />Basic Eligible Activity (c) Public Facilities and <br />Improvements. <br />B, Identify which national objective will be met. <br />B.1. If Area-Benefit, identify the boundaries of the service area. <br />8.2. If Limited Clientele-Presumed Beneficiary, Identify the <br />presumed beneficiary category and the estimated number <br />to benefit from the service <br />B.3. If Limited Clientele-Greater than 51% Low-Income (LI), <br />Identify the estimated number to benefit from the service <br />and of those the percentage expected to be low-income <br />6.4. If Low-Income Housing, Identify the estimated number of <br />housing units to be filled with low-income households. <br />B.5. If Job Creation/Retention, identify the number of job <br />created and/or retained for low-income individuals <br />C. Indicate the CDBG funding amount requested. <br />2 <br />Rehabilitation (a)(1) <br />? Area-Benefit <br />? Limited Clientele-Presumed Beneficiary <br />? Limited Clientele-Greater than 51 % Low-Income <br />® Low-Income Housing <br />? Job Creation/Retention <br />Presumed Beneficiary <br />Estimated People to be Served <br />Estimated People to be Served <br />Estimated Percentage of People who are LI <br />1 Multifamly Housing Project <br />Created <br />Retained <br />$350,000 <br />75B-87