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Neighborhood Incentive Matching Grants Program
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Steps
1.
General Information
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This section is incomplete
2.
Project Services
This section is complete
This section is incomplete
3.
Neighborhood Involvement
This section is complete
This section is incomplete
4.
Project Schedule & Budget
This section is complete
This section is incomplete
5.
Civic League or Neighborhood Organization Approval
This section is complete
This section is incomplete
General Information
Community Organization
*
Indicate Type:
Civic League / Association
Neighborhood Group
Request To Be Considered For:
Beautification
Neighborhood Improvement
Special Community Initiative Project
Contact Person
Email Address
Address
City
State
Zip Code
Phone Number
Alternate Contact Person
Email Address
Address (if different than above)
City
State
Zip Code
Phone Number
Project Name
Project Location
Amount Requested
Partnering Organization(s)
This section must be completed by the person presiding over the community organization.
Name
Title
Contact Number
Date
Electronic Signature Agreement
By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date. By completing this application, I certify that the information contained in the application is true and correct to the best of my knowledge. I certify that the contact person will be the only contact person for the project, the only person who is able to submit or request reimbursements and is a member of our community organization. If the project is approved, I understand that the city will enter into a contract with the applicant organization to ensure completion of the project as described in the application.
I agree.
Electronic Signature
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Project Services
Please describe your project in detail. (If applicable, provide the project location/address.)
Do you have the support of the adjacent property owner(s) to implement the proposed project?
Yes
No
If yes, please provide supporting documentation (i.e. letter of approval).
Will your project require the city of Portsmouth to provide a permit or approval?
Yes
No
If yes, please explain below:
Permit Explanation
Describe the maintenance required after the project is completed, who will be responsible for maintenance, and the plan for complying with the maintenance requirements.
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Neighborhood Involvement
Describe how your neighborhood will benefit from the project.
How were members of the neighborhood civic league/association (if applicable, members of the partnering organizations and/or businesses) involved in the selection and planning of the project? For example, did you have special meetings or did you survey the neighborhood for needs? (Provide documentation of any special meeting agenda or neighborhood survey).
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Project Schedule & Budget
Activity
Responsible Party
Start Date
Completion Date
Activity
Responsible Party
Start Date
Completion Date
Activity
Responsible Party
Start Date
Completion Date
Activity
Responsible Party
Start Date
Completion Date
Activity
Responsible Party
Start Date
Completion Date
Activity
Responsible Party
Start Date
Completion Date
Budget Item / Project
City Funds
Match
Total
Budget Item / Project
City Funds
Match
Total
Budget Item / Project
City Funds
Match
Total
Budget Item / Project
City Funds
Match
Total
Budget Item / Project
City Funds
Match
Total
Budget Item/ Project
City Funds
Match
Total
Describe how you will arrive at your match. Explain if your match will be raised through neighbor-labor, other volunteers, in-kind or cash donations.
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Civic League or Neighborhood Organization Approval
First Name
Last Name
Contact Number
Date
Title
Electronic Signature Agreement
By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date. By authorizing electronic signature below, I certify that I am the president of the local civic league or neighborhood organization and that I am in support of this application.
I agree.
Electronic Signature
Required Attachments
These items must be submitted in order to be considered for funding: Before Photographs (if applicable) Sketch of improvements (if applicable) Proof of 25% match including Donation Letters (if applicable) Volunteer Commitment forms and Release and Hold Harmless Agreements
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Email address
This field is not part of the form submission.
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