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CDBG APPLICATION FORM 2008: page 1 CITY OF FERNLEY, NEVADA Community Development Block Grant Application 2007 INSTRUCTIONS • Complete all applicable sections. • Place N/A where information is not applicable. • Deliver 1 (one) original application and 12 (twelve) copies to the City of Fernley, Community Development Department, 595 Silver Lace Boulevard, Fernley, Nevada NO LATER THAN DECEMBER 12, 2007 AT 5 P.M. • Applications will not be accepted after the deadline. PUBLIC HEARING: Monday, November 19th, 2007, 6 p.m., City Council meeting PUBLIC MEETING: Thursday, December 6th, 2007, 3 p.m., City Hall Chambers PUBLIC HEARING: Wednesday, December 19th, 2007, 6 p.m., City Council meeting STAFF IS AVAIABLE TO MEET ONE-ON-ONE WITH PROSPECTIVE APPLICANTS AND TO DISCUSS POSSIBLE PROJECTS. STAFF CONTACT: Rochelle Brassard, Associate Planner City of Fernley Community Development Department 595 Silver Lace Boulevard Fernley, Nevada 89408 [PHONE REDACTED] [EMAIL REDACTED] For information about application guidelines, please visit our Web site at www.CityofFernley.org and click on the link titled Community Development Block Grant (CDBG). ---PAGE BREAK--- CDBG APPLICATION FORM 2008: page 2 Nevada Commission on Economic Development Community Development Block Grant Program Tel. [PHONE REDACTED]/1812 2008 CDBG APPLICATION Complete all applicable sections. Enter NA where not applicable. Please type in spaces provided. Attach additional pages if allotted spaces are inadequate. Submit one ORIGINAL and fifteen (15) COPIES to NCED, 108 East Proctor Street, Carson City, NV 89701 by close of business on Tuesday, January 15, 2008. For further information and guidance, call the CDBG office at the above telephone numbers A. Project Title: B. Applicant Details: 1. Formal Applicant (Jurisdiction Name, Official Address and Telephone, Contacts): Name: City of Fernley, Nevada Street/PO Box: 595 Silver Lace Boulevard Town/City: Fernley, Nevada County: Lyon County, Nevada Zip Code: 89408 Chief Executive Officer: Gary Bacock, City Manager Phone Number: [PHONE REDACTED] Contact Person: Rochelle Brassard, Associate Planner Phone Number: [PHONE REDACTED] e-mail address: [EMAIL REDACTED] ---PAGE BREAK--- CDBG APPLICATION FORM 2008: page 3 2. Development/Non-Profit Agency (if applicable, e.g. Non-Profit, Housing Authority etc.): Name: Street/PO Box: Town/City: County: Zip Code: Chief Executive Officer: Phone Number: Contact Person: Phone Number: e-mail address: C. Project Administration: Provide the names and phone numbers of the following people. If the specific individual is not known, give a job title: 1. The person to whom all questions regarding the application should be directed: Name: Title: Address/City/Zip Phone: Fax: e-Mail: 2. The person responsible for maintaining the project files: Name: Title: Address/City/Zip Phone: Fax: e-Mail: 3. The person directly responsible for on-site supervision of the project: Name: Title: Address/City/Zip Phone: Fax: e-Mail: ---PAGE BREAK--- CDBG APPLICATION FORM 2008: page 4 4. The person responsible for the financial management of the project, including preparation, review and approval of draw requests: Name: Title: Address/City/Zip Phone: Fax: e-Mail: D. Project Information: 1. Background to Project: • Clearly define the problem/existing situation to be addressed by the proposed project. • What are the conditions/concerns that warrant intervention? • Explain why the proposed project is necessary. In particular, does the project address a health and/or safety concern in the community? • Explain why CDBG funds are necessary for the project. ---PAGE BREAK--- CDBG APPLICATION FORM 2008: page 5 2. Project Description: Read the following instructions carefully and provide a clear, concise description of the proposed project with maps and photographs, where applicable. Include details on the following: • location, geographic area served • size, design factors • all activities such as engineering, construction, acquisition, administration etc. • how the money (in the total budget and in particular CDBG funds) will be spent. The narrative should provide details as per the line items in the budget – see Section G • the timelines required for each aspect of the project/expenditure • the expected outcomes or results from the proposed project. What will be accomplished that could not be accomplished without the CDBG funds • how the project will meet the concerns and problems outlined above • how the project will benefit the community with emphasis on LMI persons • in the case of limited clientele projects, explain how the beneficiaries will be counted • in the case of housing rehabilitation projects, indicate the number of houses to be rehabilitated • in the case of planning only grant applications, indicate the goal of the proposed plan, if the plan is for short- or long-term planning, how the benefits from the plan will benefit LMI persons, and if the plan will address a public health or safety concern in some manner • for economic development projects, where assistance is being provided to for- profit business(es), include a commitment letters from the employer(s) explaining how they will comply with the 51% job creation requirement. If letters are not available (e.g.in the case of industrial park development), explain how the site will be marketed and jobs created and counted. • prior work related to the project (e.g. PER, architectural drawings, feasibility study) • why the project will be feasible Note: A grantee applying for funding for the construction or rehabilitation of a facility must be able to show that sufficient revenue is in place to continue the operation of the facility, or describe how revenue will be obtained to ensure continued operation of the facility after completion. (Please use the space provided below and the following page as needed.) ---PAGE BREAK--- CDBG APPLICATION FORM 2008: page 6 ---PAGE BREAK--- CDBG APPLICATION FORM 2008: page 7 3. Project Phasing: • Is the proposed project part of a larger project or is it a stand-alone project? • Can the proposed project be implemented in different phases? If yes, please explain • Have CDBG funds been used for an earlier phase or for prior work related to this project? If yes, please provide details • Comment here, with details, on how ready the project applicant(s) is/are to implement the proposed project, for example: o Commitments from other funding sources (except CDBG) o Status of the Environmental Review o Status of prior work/preliminary planning. (Has a plan or study in connection with this project been conducted? When and by whom? What were the conclusions?) o capacity within the jurisdiction/implementing agency to implement the project o are rights-of-way, easements or other access rights acquired? Are all other permits in place etc? ---PAGE BREAK--- CDBG APPLICATION FORM 2008: page 8 4. Project Context: • Has the project been identified within the context of a wider local planning process? If yes, provide details (e.g. part of a Master Plan, Debt Management Plan, Capital Improvement Plan, Regional Plan, Economic Development Plan, Housing and Community Development Needs Assessment, Silver Star Community Plan etc.) • If this project has been identified in any local planning process, provide the title and relevant page numbers of the planning document in which the project is identified. • If the project has been identified in a local planning process, explain how the project meets the objectives of the plan E. Federal Requirements on Project Eligibility: Refer to the HUD Guide to National Objectives and Eligible Activities for State CDBG Programs. If you do not have a copy check the web page at: www.hud.gov/offices/cpd/communitydevelopment/library/stateguide 1. Eligibility: Select the eligible activity that best describes the project, and cite the reference from the Housing and Community Development Act, Section 105: Section 105( ) Type of activity (e.g. Acquisition of Real Property, Public Facilities and Improvements, Public Services etc.): 2. National Objective: All projects must meet a National Objective. Check only one of the three National Objectives that the project will meet in the boxes below ---PAGE BREAK--- CDBG APPLICATION FORM 2008: page 9 1. BENEFIT TO LOW AND MODERATE INCOME (LMI) PERSONS If selecting this National Objective, choose one of the following and provide the necessary supporting information: City/County-wide LMI Limited Clientele LMI Site Specific LMI Economic Development LMI (Survey required) LMI Housing 2. ELIMINATION OR PREVENTION OF SLUMS AND BLIGHT If selecting this National Objective, all of the following must be included with this application: Slum/Blight Criteria selected Additional Documentation (Photos, Letters from Officials etc.) Slum/Blight Declaration/Resolution 3. URGENT HEALTH AND WELFARE THREAT If selecting this National Objective, all of the following criteria must be met: Determination of immediate threat – when and by whom; include documentation Applicant’s inability to finance Confirmation that no other financial sources are available Confirmation that threat did not exist for more than 18 months prior to application ---PAGE BREAK--- CDBG APPLICATION FORM 2008: page 10 3. Performance Outcome Measures: Select one of the following that best fits your project objective: Suitable living environment Decent affordable housing Creating economic opportunity Select one of the following that describes the outcome your project will achieve: Availability/Accessibility Affordability Sustainability F. Project Beneficiaries: 1. Number of Beneficiaries and Data Sources: Please complete the following table as it pertains to this specific project, and attach all relevant and appropriate supporting information: Persons Jobs 1. Total number of beneficiaries/jobs 2. Total number of low/moderate income beneficiaries 3. Percentage of LMI beneficiaries (Divide line 2 by 1) % 4. How were these figures obtained? Census, survey etc. Tract Block Group 5. Census Details Date Attached Y/N 6. Survey Details 7. Other details/comments on beneficiary figures ---PAGE BREAK--- CDBG APPLICATION FORM 2008: page 11 Indicate below the number of persons in the following protected classes within the targeted population: Female Heads of Households: Elderly: Handicapped: 2. Race and Ethnicity Data: HUD requires grantees to select and report racial/ethnic data on activity beneficiaries from 10 racial categories and a Hispanic ethnic category. Note that the Hispanic ethnicity category cuts across all races. Those reported as White, Black, Asian, Pacific Islander, American Indian or Other Multi-Racial may also be counted as Hispanic. The total under the column headed ‘Hispanic’ cannot exceed the Race column total. Using the total number of beneficiaries (Line 1 above), please complete the following table. Race Category Number of Beneficiaries in Racial Category Number of Beneficiaries who are also Hispanic 1 White 2 Black or African American 3 Asian 4 American Indian or Alaska Native 5 Native Hawaiian or Other Pacific Islander 6 American Indian or Alaska Native and White 7 Asian and White 8 Black or African American and White 9 American Indian or Alaska Native and Black or African American 10 Balance/Other Total ---PAGE BREAK--- CDBG APPLICATION FORM 2008: page 12 G. Financial Information: 1. Project Budget: Please complete the following table which summarizes the budget categories and funding sources for the proposed project. Provide details (after the table) on the nature of the In Kind contributions. Also, indicate in the space provided under the table, if the non-CDBG funding sources have been secured. If so, attach letters of commitment for all cash matching funds, and comment on when unsecured funds will be secured/confirmed. Project Title: Cost Category CDBG Local State Other Federal Other Totals Cash In Kind Land Acquisition Legal Expenses Appraisals Architectural Engineering Administration Demolition Site Work Construction Materials Equipment Inspection Other: 1. 2. 3. Total Costs ---PAGE BREAK--- CDBG APPLICATION FORM 2008: page 13 Nature of In Kind contribution: Specify “State” funding sources: Specify “Other Federal” and “Other” funding sources: Which non-CDBG funds have been secured already? Explain when unsecured funds will be confirmed: For each Cost Category item shown above, explain how the cost was determined, the source of the cost estimate and any other information you believe necessary to explain the cost and necessity of the item. If the project involves construction, please allow for inflation in relation to the anticipated start date of the project and use the Davis-Bacon labor rate in estimating labor costs. If necessary, include additional details in an attachment to this application. ---PAGE BREAK--- CDBG APPLICATION FORM 2008: page 14 2. Operational Information: a. Who will be responsible for the maintenance of the equipment or facility? b. Who will pay the operation and maintenance costs of the equipment or facility? c. How will the operation and maintenance costs be met? d. If this request is for a water or sewer project, please complete the following Utility Cost Table: Water system Sewer system Total costs Number of customers Average residential usage Current rates Charge to connect to system Average cost for residential customers Date of last rate change Amount of last rate change e. Solid waste projects: 1. Current rates: 2. Date of last rate change: 3. Amount of last rate change: f. If a fee will be charged for the services provided (other than water, sewer or solid waste disposal) in connection with the project, describe the fee structure in detail (for example ambulance fees): ---PAGE BREAK--- CDBG APPLICATION FORM 2008: page 15 3. Matching Funds: Please complete the following table which summarizes the amount and status of CDBG and matching funds for the proposed project. The information for this table can be extracted from the previous budget table and notes. Project Title: Funding Source Cash or In Kind Grant or Loan Amount % of Total Committed (Y/N) If not – when? (mm,dd,yy) CDBG Cash In Kind Grant Loan Y N Local Cash In Kind Grant Loan Y N State Cash In Kind Grant Loan Y N Other Federal Cash In Kind Grant Loan Y N Other Cash In Kind Grant Loan Y N Total H. Environmental and Other Impacts: 1. What level of environmental review is required for the proposed project? Environmental Impact Statement (EIS) Environmental Assessment (EA) Categorically Excluded/Does not convert to Exempt Categorically Excluded/Converts to Exempt Exempt Not known at present 2. At what stage is the environmental review process at this time? 3. If other state or federal agencies are involved in this project and require an environmental review, provide the name and address of the agency and the name and phone number of the contact person at that agency. ---PAGE BREAK--- CDBG APPLICATION FORM 2008: page 16 4. What are the anticipated short-term and/or temporary environmental impacts associated with this project? Describe both positive and negative effects and, if necessary, proposed mitigation measures. 5. What are the anticipated long-term and/or permanent environmental impacts associated with this project? Describe both positive and negative effects and, if necessary, proposed mitigation measures. 6. Indicate whether the proposed project involves any of the following: 1. Historic structure (designated or 50+ years old) Yes No 2. Historic or prehistoric site Yes No 3. Historic District Yes No 7. Will this project require or result in the involuntary displacement of any person? Yes No 8. Describe any positive and negative impacts, other than environmental, which are expected as a result of this project. Quantify as much as possible. If necessary, include additional details in an attachment to this application. ---PAGE BREAK--- CDBG APPLICATION FORM 2008: page 17 I. Public Participation: Each applicant must provide evidence of an effective citizen participation process with regard to this application: Each applicant is expected to: • hold an initial public meeting to obtain citizen input into the types of activities to submit for funding, • publish a notice with specific details on the applications that are being submitted. This must be followed by a 2-week comment period, and • hold a second public meeting to discuss any comments on the proposed applications, and to finalize the applications prior to submission to CDBG. (Refer to pages 10 and 11 of the CDBG Grant Application Handbook). Please complete the following: 1. Public Meeting Date of Public Notice: Date of Public Meeting : Attach copy of publication notice. Attach copy of the minutes from the meeting . List all persons attending the meeting (for the purpose of discussing the CDBG Program and potential applications) and the contributions of all who spoke at the meeting . 2. Public Notice (requesting comment on the proposed applications): Date of Public Notice: Attach copy of publication notice 3. Public Meeting Date of Public Notice: Date of Meeting : Attach copy of publication notice. Attach copy of the minutes from the meeting . List all persons attending the meeting (for the purpose of discussing the CDBG Program and potential applications) and the contributions of all who spoke at the meeting . ---PAGE BREAK--- CDBG APPLICATION FORM 2008: page 18 J. Application Checklist: Use the following checklist to ensure that the submission is complete. Check the spaces provided and enter NA where not applicable. Submit the completed checklist with the application. • Is the Summary Page complete, with the appropriate HCDA reference, National Objective information, details on funding, signature of City Mayor or County Chairperson etc? • Have all the spaces in the application form been completed (with comments or NA)? • Is all the requested and necessary supporting information attached? For example: o Maps, photographs and other attachments in support of the project description o Letters from potential employers in support of specific economic development projects o Specific information required for Slum and Blight projects o Specific information required for Urgent Need projects o Census data in support of the application o Survey data and supporting information o Letters of commitment confirming matching funds already in place o Additional cost and budget information • Evidence of Public Participation regarding this particular application • CDBG Disclosure Report signed by the Mayor or Chairperson • Annual Participation Statement • Community Development and Housing Needs Assessment • Other Attachments (Specify) Complete all applicable sections. Enter NA where not applicable. Please type in spaces provided. Attach additional pages if allotted spaces are inadequate. Submit one ORIGINAL and fifteen (15) COPIES to NCED, 108 East Proctor Street, Carson City, NV 89701 by close of business on Tuesday, January 15, 2007. For further information and guidance, call the CDBG office at the above telephone