POLK COUNTY APPEARANCE COMMISSION GRANT APPLICATION FORM
All work MUST comply with the appropriate Grant Guidelines.
(Please type or print clearly in blue or black ink.)
Applicant Name ______________________________________________________________________________
(Last) (First) (MI)
Property Physical Address_____________________________________________,
Business Name ________________________________________________________________________
Mailing Address _______________________________________________________________________
Date: (mm/dd/year) _______________________ Phone ____________________________________
I am the (check all that apply):
? Property Owner and/or the ? Business/Government Entity
Applicant must print and sign name. If applicant is NOT the owner of the property the property owner must print and sign name and check the box approving that he/she is in agreement of the applicant’s application and the proposed work.
Applicant _____________________________________________; ________________________________
Print Name Applicant Signature
Property Owner _____________________________; ________________________________________
Print Name Property Owner Signature
As property owner, I approve of this application that is being submitting by my tenant.
The Appearance Commission will seek to award grants in diverse locations throughout the geographic area of Polk County.
Selection Criteria Include:
* Street appearance
* Public Enhancement
* Tasteful landscaping including but not limited to trees, shrubs and flowers
* Well maintained property
* Effort rather than cost
* Creativity and effort combined
* Structural improvements
* Property in compliance with existing codes, taxes, etc.
* Property used by and for the public
* In kind work, may be used for matching funds
Structural improvements for grant purposes include exterior renovations to the building that are visible from the street or sidewalks. These will also including signage, awnings, planters, fountain features and similar elements.
Deadline for grant applications is Febuary 28th.
Notification of grant awards, March 1st.
Monies must be spent and receipts submitted by May 31st.
Improvement Information: On attached sheet(s) describe your proposed improvement project: provide samples, “before” photographs, pictures, or a rendering; show size; proposed color(s); method of cleaning brick storefronts; materials; location on property/building; manner of installation, and necessary permits from the city or Polk County. We will also need to have a copy of your budget. You may be required to meet with the Polk County Appearance Commission.
Estimated Date of Completion of Work: __________________________________________________
* Approved as Submitted
* Approved with Modifications or Conditions (see attached)
* Rejected (Reasons for rejection attached)
Reimbursement will be made to applicant after work is completed and pending approval from the Design Review Committee or Designee for Design Review Committee.
Payment Info: ? Approved for Reimbursement ? Rejected for Reimbursement
____________________________________________________________ Date _____________________
Appearance Commission Representative
Grants will be made for up to $1,000 and must be matched by the applicant.
(All documentation stating that the work has been paid for must be attached for reimbursement. No Reimbursement can be given without documentation)
Polk County approved Reimbursement $ _________________________
Date of requested funds: ______________
Date of approval of funds: _____________