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ELK RIVER ECONOMIC DEVELOPMENT <br /> MICROLOAN FUND APPLICATION <br /> I. CONTACT INFORMATION <br /> Legal Name of Business: Heritage Millwork, Inc. <br /> Project Site Address: 15725 Jarvis <br /> City / State / Zip Elk River, MN 55330 <br /> Contact Person(s) Annie Deckert, Decklan Group, Pat Menth, Heritage Millwork <br /> Business Phone 763-568-9498 (Annie), 763-323-7501 (Heritage Millwork) <br /> Email annie@decklangroup.com <br /> Check One: Proprietor X Corporation Partnership <br /> Social Security No. <br /> Federal ID # 41-1864718 State ID# 3129323 <br /> 2. NATURE OF LOAN REQUEST <br /> Which Micro-Loan Program are you applying for? <br /> X Industrial Incentive Program <br /> Downtown Revitalization Financing Program <br /> Energy Efficiency Improvement Program <br /> Jobs Incentive Program <br /> Amount Requested: $ 100,000 Total Project Cost: $ 2,045,900 <br /> Type of project: <br /> New construction for a start-up business <br /> New construction for an existing business <br /> On site expansion <br /> X Equipment purchase <br /> Remodeling: (circle one)Commercial/Retail/ Industrial <br /> X Other Building purchase <br /> Page 2 of 8 Fpiiiiii � <br />