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8.1 HRSR 05-04-2015
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8.1 HRSR 05-04-2015
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5/1/2015 11:48:56 AM
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City Government
type
HRSR
date
5/4/2015
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<br />VIII. DEMOLITION <br /> <br /> <br /> Applicants are encouraged to first consider the Elk River Fire Department's house burning/training <br />program demolition option or submit three demolition bids. <br /> <br /> <br /> <br />IX. CERTIFICATION <br /> <br />Have any of the owners ever gone through bankruptcy? Yes No <br /> <br /> <br />If yes, when? __________________________________ <br /> <br />Are all current and previous taxes due paid in full for the property and owners? Yes No <br /> <br /> <br />If no, please identify business/property for which there is delinquent taxes and the circumstances surrounding the <br />delinquency: <br />____________________________________________________________________________________________ <br /> <br /> <br /> <br />X. SIGNATURES <br /> <br />By signing this form, I/we acknowledge that I/we have been informed of my/our rights regarding information <br />collected from and about me/us for the purpose of determining my/our eligibility for the Elk River Program and <br />its ongoing administration. <br /> <br />I/We understand that the information in this application will be used to determine eligibility for the Elk River <br />Program and that this information will be verified. <br /> <br />I/We, the undersigned, certify, subject to penalty under Federal law, that the above information is true and <br />correct to the best of my/our knowledge and belief, and I/we understand, accept and agree to the above <br />provisions. <br /> <br /> <br />PLEASE SIGN BELOW: <br /> <br /> <br />_________________________ __________ _________________________ __________ <br />Applicant Date Co-Applicant Date <br /> <br /> <br />181302v1 <br />9 <br />
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