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ELK RIVER ECONOMIC DEVELOPMENT <br />MICRO LOAN FUND APPLICATION <br />I. CONTACT INFORMATION L~~1~ G;-~~(:l C~°~i~~~ I1'1 C~ ~~~ <br />Legal-Name of Business: `~c`~ YY~~i~~ ~ ~ ~ O' '- h C, <br />Address: _1 ~ 03 1 ~ t- t~o~~• ~t,~P, ~ O ~~ <br />City /State /Zip <br />Contact Person(s) <br />Business Phone <br />Home Phone <br />Check One: <br />t <br /> <br />~, 1~-~~~~~ ~ ~~ Fax. <br /> <br />_~ Proprietor Corporation Partnership <br />Social Security No. <br />Federal ID #-{(~- () i~~-5 J ~ State ID # .~`~ In J~ 0'~2 / <br />II. NATURE OF LOAN REQUEST <br />~~hich NLicro-Loan Program are you applying for? <br />Industrial Incentive Program <br />Rehabiliation Financing Program <br />Downtown Business Revitalization Loan Program <br />Amount Requested: $ O Total Project Cost: $ (~ ~ , ~ ~ t) <br />Type of project: <br />New construction for a start up business. <br />__ Ne~v 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 f71~v1.(~L'i ~,i S l l'1~~~11 i Sal > ~ ~~~~~1,~~~.5~ <br /> <br />Vlicio Loan Ftmd Application Page 9 of 14 <br />Amended November 2006 <br />