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ELK RIVER ECONOMIC DEVELOPMENT <br />MICRO LOAN FUND APPLICATION <br />I. CONTACT INFORIVIATI®N <br />('(~uM~ ~R~ (~~c!`S ALL <br />Legal Name of Business: r <br /> <br />.-~dclress: 7 iv ( n <br />•- l `/ 5 ~.~~ <br />~ ~-~ lbw <br />S~;•r~ <br /> <br />City / SCate /lip ~ h~ <br />~ /11 5 ~-- y <br />/~) /`N <br />. 5 .S .'3 ~ ~3 <br />Contact Person(s) 1•_) V ~ ,~.'~ /--~/t S j ~ r ~2 ~Z ~% 02~~ N 1/ ~ TS ~-~' ~_11' 2 ~ .$ , ~)v~,~-7) <br />Business Phone ~ ~' .~3 ~ j ~ G -- ~/G' ~j O Fax 1 ~ ~ ~ ri 7 ~ •--- `~`7~~7' ~~ <br />L ,iLL !~ / <br />1Phone 7~ ~ ~,~ 1 ~-~ 4~~ 5^~ ]~mail_-~l ~~ S S c~ ~v~ ~ ~vS' S ~~ ~-y~, GC/j-t <br />Checl; One: nr~,,,-ier~r ,X _ __Corporation Partnership <br />Social Security No. <br />---~~ <br />~ % ,~ ~ ~ ~ / State ID # ~J of ~r j yC ~ s <br />IT. NATURE OF LOAN REQUEST <br />~`Vhich 1\4icro-I..oan Program are you applying for? <br />~`~ Industrial Incentive Program <br />Rehabi.Liation T'i~ancing Program <br />Downtown Busiiess Revitalization Loan Program <br />Amount Requested: ~ ~ ~~ Ga ~ Total Project Cost: $~~/ b'~~'•- ~~~ C,oo <br />Type of project: <br />New construction for a start up business. <br />New construction for an existing business, <br />On site expansion <br />I~quipmcnt purchase <br />_~ Remodeling: (circle u~~eJ Commercial /Retail / Industrial <br />Refinancing existing debt <br />Other <br />~4icro Loan Fund .\pplirition ~ Payc 9 of 14 <br />;lmcnded Not~cmber 2006 <br />