SW0501-CS050216 (2)FY2005 DALLAS COUNTY CDBG
PROJECT/ACTIVITY APPLICATION
Please complete a separate application for ~aclt proposed pro|ect/activit~.
NAME OF CITY
TITLE OF PROJECT
(1) Number of beneficiaries
(2)
Percentage of beneficiaries being
low/moderate income
O)
How was number of beneficiaries/percentage of beneficiaries being low/moderate income
calculated?
[ ] by a survey conducted on
[ ] by 2000 census data
[ ] other, explain
If census data is used please provide the census tract and Mock group information:
Tract Block Group.
Tract Block Group.
Tract Block Group
(4)
(5)
Identify which national CDBG objective this project addresses:
[ ] primarily assists low/moderate income
[ ] eradicates blight
[ ] eliminates community-threatening condition
[ ] n/a (to be used for consultant studies and projects involving ADA accommodations
and the elderly which are assumed to automatically address a national objective)
Is the service area for this project city-wide?
[ ] Yes
[ ] No If no, a map with the project's service area boundaries clearly marked must
be attached. For capital improvement projects, the map must clearly show
the location of the project and its beginning and ending points.
(6)
Describe proposed project. This description should adequately explain what will be
undertaken, where it will occur, why it needs to be undertaken, and what problems it will
solve. Please be very specific in the description-if, for instance, the proposed project
involves improving a road or replacing a water line, be sure to state that the project will
cover a certain amount of linear feet fi:om Point A to Point B.
(7)
Project represents:
[ ] newpmjecffactivity
[ ] continuation of on-going activity (i.e., code enforcement)
[ ] completion of an existing project (i.e., a project-usually a capital improvement
project--that has received funding in the past, but still needs additional funding in
order to be constmcted)
(8)
Will project require the acquisition of any needed land or easements?
[ ] Yes
[ ] No
(9)
Attach a line-item budget for the proposed pmj ect~activity. Describe within this budget how
proposed costs are derived. For capital improvement projects, also provide itemized costs
and quantifies for such components including, but not limited to, right-of-way/easement
acquisition, surveying/engineering design, utility relocation, construction management,
materials, and permits/fees. Where possible for capital improvement projects, have the
estimates provided by a licensed professional engineer.
(10)
Describe how projecffactivity is to be funded:
· FY2005 CDBG funding being allocated
· CDBG funding from completed/canceled
pmjeets now being reallocated
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· Previous CDBG funding that ha~q been allocated
· Non-CDBG funding that has been allocated
· Additional funding still needed
TOTALBUDGET
(11 ) If .c~ty-over CDBG funding from previous projects is going to be used, identify the previous
projects fi'om which this funding is being reallocated and the amounts being reallocated.
(12) If non-CDBG funding is to be used, describe whether this funding has already been secured
or when such funding will become available.
(13) If additional funding will still be needed, describe how additional funding will be provided
(e.g.-through future CDBG funds, city bond program, etc.).
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(14)
Describe what portions of the project, to the extent applicable, that will be implemented/
managed by the County, the City, another organization, or some combination of these
entities. Dependingupontheproject, these p°rtions eould include being responsible forthe
engineering design of the project, bidding the construction of the project, hiring staff, hiring
contractors, coordinating the relocation of utilities, managing consultant contracts, inspecting
construction, and/or acquiring needed land.
(15) Proposed start date for implementing project
(16) Proposed completion date
(17) Date(s) of public hearing(s) held by City to identi~ possible projects:
Contact person for project: _
Phone number:
Fax number:
Authorized signature:
(Please type or print)
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