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� • r�/ t n r q <br /> , � L�'1 ���.1�:.���1 S��LL•'•C�Z U��/1���S ���ZUU�I��I.•'' <br /> � . — �� � ni�i��icn�rzu�i � <br /> � IJot-l=vr-I�rofil: Reci��ienL' 11ye►�cy:. 11�,�1 ical:ioii I're��araLiuit CviiLacL: <br /> � (Local Gover�unenL, if applicable) <br /> llecaLur—Placou Counly' <br /> 11y� Pdatne Opporl-unilies Corpora�iou 1lyency fJame <br /> Coi ��t Pei'son _.�ir,(�( �j�,;,,, ConLacl; I'ersoii <br /> SLreeL' 11z2 1;�.,s� rla.�i�r -,.�,� SLree� <br /> ri1;y vecacur Ci1:y <br /> � ��.aLe 11,. Lip G2521 SLa1:e Zip <br /> 1'holte 217/42�-U155 Phone <br /> IJoL-For-I'rof�iL Fein �I 37-OIIG4-527 Coui�Ly: rtacou Couutv <br /> A��plicliiL's riscal Year 3/1/91-2/28/92 <br /> I'rojecl: Sunuii�ry: llriefly describe the proposed project <br /> To renovaLe one l�ouse L-o be used Uy ho�neless persous and provide tor repal.rs to <br /> auoClier liouse, wlitcli l�as Ueen used as an �me�rgency sl�eJ.l-er by ll�iCUC Lor 15 vears. <br /> I'ro��osecl ;uncl i i�y: 1lmounL LSGI' Expe�ises <br /> ESGl� !1n►oui�l; � 44,500 Renovai:�ion/Rehab. $ 40,700 <br /> �List �4atchiny � 2,50o Conversion $ <br /> Funds � 8,00o EssenL-ial Services $ <br /> � � 34,UU0 Operal;ior�s � 3,800 <br /> � _ PrevenLion $ <br /> $ <br /> $ � TUTIIL � 44,500 <br /> . Type of Shel Ler Cmergencv Shelt-,�,r' <br /> ,(progranunaCic) <br /> ToLal I'rojecl: Fundirig :; 89,000 <br /> l:sLimaLed Services: '•,� <br /> . . <br /> , �'uin�er o� tleds Avai 1 abl e � � . 12 <br /> � IJumber o E3edn��hts � 12UU <br /> � tJumber of Undu;�l i cated !lomel ess � <br /> f�er�oris Served Per Moi.�ti .� . � ' � �d <br /> Utilier (Uescribe) <br /> 1 o I:lie bes� o f my kiio�•�l ecly�+ ancl Uel i+���� , data i i� i:h i s appl i cai:i on i s i:rue and <br /> c:orrecL, tiie documeiit has �eer� :::�ly authorized by the yoveri�ing body of ttie <br /> a��plicaiiL and 1;1�� applicanL wi i i comply wiLh 1:he aL-tached assurances if the <br /> =:;�uli�aL-iou �is a;.;�roved <br /> \ Executive <br /> �, C� uG�J Director April 11, 1991 <br /> SiyiiaLure of Chief Eleccc:; Official Title UaLe Signed ', <br /> or llutl�orized Officer � <br /> IMPORTANT NOTICE � ' • <br /> Ilris sr,re dOCl1f.)�is r�qucsting diar.losure vl ir�/orntalion fdet!t necesserp(n nr.corrry�li�l,the it�fulo�ypurpo:c es ouNined under p! Rr.�� <br /> Siarc Cl,a�r. 127, /:v�a. qr, / c�, req. Uisclv�we vf Uiis in/om�n(ion ia lJ£UUlIT[U, f�ilure 10 p►ovide ary lnlonnecio►►�vill result�n fh�� <br /> IOIl�I lltlf II/.'lll9�'�UCCJJCC �his/om�has Gemr opproved by the S1a1e Fomit Afan�yemeirt Cer►ter. �'�, <br /> Form !!I i. •120-t (2/91) -11- . - 'I <br />