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Community Development <br /> Block Grant <br /> AN xa <br /> COUNTY <br /> Please complete the following Project application. An Application Guide is <br /> available with directions on completing the application, submission details, and <br /> contact information for questions regarding the application. <br /> General Project Tide: Residential Water Hookup to DUNS It: Waiting to apply for one until <br /> Information watermain after grant is awarded <br /> Applicant Organization /Agency: City of Centerville <br /> Type of Local Government ❑ Non -Profit Organization <br /> Organization ❑ Public Agency ❑ Institution of Higher Education <br /> ❑ For - Profit Organization ❑ Anoka County Department: <br /> ❑ Faith -Based Organization <br /> Contact Person: Mike Jeziorski Tide: Finance Director <br /> Address: 1880 Main Street <br /> • <br /> City: Centerville State: MN { Zip: 55038 <br /> Phone: 651 -429 -3232 Email* mjeziorski @centervillemn.com <br /> Fax: 651 -429 -8629 *meeting notices will be sent by email only. <br /> Project Project Address: Throughout City Project Service Area: Throughout City <br /> Information Does the total project cost, reflected below in "Funding Request," account for federal <br /> prevailing wages? (Reference the Application Guide for information on federal wage laws) <br /> ® Yes ❑ No <br /> This project will be completed in: ❑ 6 months ® 12 months ❑ 18 months <br /> Project Activity 03J (Select the HUD activity listed in the Application Guide that best fits <br /> this project; example: 030 Fire Station) <br /> If this is a phased project, can this phase stand alone? ❑ Yes ❑ No <br /> Will CDBG funding be used to leverage additional funding? ❑ Yes ® No <br /> Funding Amount ($) of CDBG Request $ 215,000.00 <br /> Request Amount ($) of Community or Agency's Resources $ 0.00 <br /> Amount ($) from Other Sources $ 0.00 <br /> Total Project Costs ($) $ 215,000.00 <br /> • <br /> Anoka County CDBG Project Application <br /> 45 <br />