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St?C,"I'lON 2 f'ftOJ}:;,C'[' (N}�011M11'C'(0�1 <br /> APPLICANT INFORMATION <br /> Applicant Name: <br /> Mailing Address: <br /> Phone Number: <br /> Fax: <br /> E-Mail: <br /> GRANTEE INFORMATION <br /> Grantee Name: <br /> Grantee Social Security Number OR: <br /> Federal Employer ldentification Number (FEIN): <br /> PROPERTY OWNER INFORMATION <br /> Same as grantee? YES NO <br /> Name(s) of property owner(s): <br /> Owner(s) phone: <br /> BUILDING INFORMATION <br /> Business Name: <br /> ❑ Individual ❑ Corporation ❑ Partnership ❑ Other <br /> How is the title held to the property? <br /> ❑ Individual ❑ Corporation ❑ Partnership ❑ Other <br /> ❑ Land Trust ❑ Limited Liability Company <br /> Building Name: <br /> Building Address: <br /> TOTAL ADDRESSED BY PROJECT <br /> Parcel square footage: <br /> Building square footage: <br /> Number of floors in building: <br /> 5 � l' �� �; t' <br />