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ELK RIVER ECONOMIC DEVELOPMENT <br /> MICROLOAN FUND APPLICATION <br /> 1. CONTACT INFORMATION <br /> Legal Name of Business: t s - " <br /> Project Site Address: I �o e <br /> City / State / Zip IS <br /> Contact Persons) " <br /> Business Phone (ell — Fax 7-IM Q <br /> Home Phone °' Email d A( "T E <br /> Check One: Proprietor Corporation Partnership <br /> Social Security No. — �- <br /> Federal ID # State ID # 3 <br /> 2. NATURE OF LOAN REQUEST <br /> Which Micr Loan Program are you applying for? <br /> Industrial Incentive Program <br /> Downtown Revitalization Financing Program <br /> Energy Efficiency Improvement Program <br /> Amount Requested: $�2 00, 000 Total Project Cost: $ <br /> Type of project: <br /> New construction for a start-up business. <br /> New construction for an existing business. <br /> On site expansion <br /> Equipment purchase <br /> Remodeling: (circle one) Commercial/ Retail / Industrial <br /> Refinancing existing debt <br /> Other <br /> Page 10 of 17 P © NERE0 ® E <br />