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Distance from nearest major roadway: 0 More, or ❑ Less than 1,000 feet <br /> Distance from nearest municipal or military airport: Q More, or ❑ Less than 5 miles <br /> Wetland Protection <br /> Is there a wetland associated with the proposed project? ❑ Yes 0 No <br /> Flood Hazard Area <br /> Is there evidence or knowledge that a portion of the proposed project is located in a 100- or 500 - <br /> year flood plain? ❑ Yes ❑■ No <br /> Other Does the project: <br /> • Include repair, rehabilitation, or conversion of existing building /facilities? <br /> ❑ Yes 0 No <br /> • Involve new construction, acquisition of undeveloped land or any construction that <br /> requires ground disturbance? <br /> 0 Yes ❑ No <br /> G ,x fig,. <br /> Wrt 10 V �E <br /> .:? ��u�$n;. q �b*c <br /> t <br /> As an applicant requesting funding, will any of your employees, agents, consultants, officers, or <br /> elected officials meet any of the following conflicts of interest: <br /> ❑ YesO No Participate in the decision making process for the approval of this application? (i.e., an Anoka <br /> County Commissioner or HRA Trustee) <br /> ❑ Yes❑M No Have a financial interest or reap a financial benefit from this activity? <br /> ❑ YesO No Have an interest in any contract, subcontract, or agreement with respect to this application <br /> either for themselves or those with whom they have family or business ties during the program <br /> year and for one year thereafter? <br /> If "Yes" to any of the above, please identify the situation: <br /> #, _'c* t " -- <br /> Select ONE type of beneficiaries this project will address and the number of expected accomplishments. <br /> ❑ Area or Spot designation <br /> ❑■ <br /> Households- Enter # households 37 households <br /> ❑ People - Enter # unduplicated people <br /> ❑ Businesses - Enter # businesses <br /> ❑ Housing Units - Enter # units <br /> ❑ Jobs - Enter # jobs <br /> ❑ Public Facilities - Enter # facilities <br /> ❑ Demolition /clearance - Enter # units <br /> Anoka County CDBG Application <br /> C�� <br />