Instructions:  Please complete each section and submit the following narrative questions. Answer the questions with detailed descriptions and provide supplemental documentation, when applicable.
Applications must be submitted by 12:00 p.m. on Monday, October 3rd, 2022.
If you have completed the Online Application, you do not need to complete this form.
Manufactured Home Park and Applicant Information	
Name of Manufactured Home Park	     	
Park Address	     	
Name of Ownership Entity of Manufactured Home Park	     	
Address of Ownership Entity	     	
Primary Park Contact Name and Title	     	
Primary Contact Phone	     	
Primary Contact Email	     	
When Applicable:	
Name of Intermediary Organization	     	
Primary Intermediary Contact Name and Title	     	
Primary Intermediary Phone	     	
Primary Intermediary Email	     	
What is the ownership structure at the time of application (i.e., privately owned, cooperative, nonprofit owned, etc.)?	     	
What will the ownership structure be at project completion?	     	
Lot Information	
How many lots are in the park?	     	
How many lots are vacant?	     	
How many lots are occupied by rented homes?	     	
How many lots are occupied by homeowners?	     	
How many lots are occupied by seasonal homes?	     	

Project Information
1.	What amount of funding are you requesting?      
2.	What is the estimated total project cost?      
3.	Are you applying for funds for Infrastructure Redevelopment, Acquisition, or Both?      
4.	Select the type of Infrastructure Redevelopment that is included in your project proposal:
	Water and Sewer System 
	Repair System
	Replace System
(Selecting this box prompts the question): 
Does the system require a Subsurface Sewage Treatment Systems (SSTS) permit?
	Yes
	No
Does the system require a State Disposal System (SDS) permit?
	Yes
	No
Estimated gallons of water per day pass through the system:
	Electrical System
	Repair
	Replace
•	Number of lots impacted:
	Road and sidewalks
	Repair
	Replace
•	Estimated square footage of improvements: 
	Storm Shelters
	New Construction
•	Type of structure:
	Repair existing
•	Estimated square footage of structure: 
	Other
Please describe:      

5.	How will you monitor the use of grant proceeds to ensure all improvements are completed diligently and in compliance with all applicable state and local requirements?
     
6.	Are you or have you been involved in litigation with a park community member, board or representative? If so, please describe the action and outcome. 
     

Community Needs
7.	Describe the manufactured housing community. Is it a residential, year-round park? Are there areas of the park that are seasonal? Describe any unique aspects of the park, the residents and/or the community.
     
8.	How will this project benefit the manufactured housing community? Describe, in detail, the needs of the park. Describe how the funds will be used to address the needs of the park.
     
9.	Are there any immediate or critical health and safety issues that need to be addressed in the park? If yes, describe what the issues are.
     
10.	Is there a risk that the park will close or that the property will be converted to another use if this project is not completed? If yes, describe what the risk of park closure would be.
     
Households Served
11.	What are the lot rents in the community? What utilities or services are included in the lot rent? Complete the Applicant Workbook, including details of the rent for each lot.
     
12.	Have lot rents increased more than 5% per year within the previous three years? How often have lot rents increased and what is the process for calculating increases?  Include the most recent rent rolls for the past three months.
     
13.	What is the range of income for households living in the community? Describe the people who live in the community. Provide any documentation you have that illustrates the range of income of the households (i.e. survey of residents, information from tenant applications, city or county data, etc.)
     
14.	What are the demographics of the people living in the community? Do the residents represent typically underserved communities (i.e. black, indigenous, or people of color, people with disabilities, immigrant communities, etc.)? Provide any documentation you have that illustrates the demographics of the residents.
     

Community Support
15.	Describe how the surrounding community is involved in the project. Is a local government, nonprofit, or community organization involved in the acquisition or infrastructure improvements? 
     
16.	Describe the role the park community plays in the town, city, county or region. What efforts, if any, have you personally made to bolster this role?
     
17.	Is any portion of the project funded by a local municipality or another entity in the community? Will the city or local organization be contributing resources, discounts or waivers to help with project costs? If yes, describe the source of the funds and state the dollar amount. 
     

18.	Are any of the utilities in the park public utilities at the time of application, or will any utilities be converted to public utilities with this project?  If yes, please describe.
     
19.	Does the park have a resident association or other body representing the residents of the manufactured park? If so, how will you engage this body in the process of identifying and carrying out needed infrastructure improvements? If not, how will you identify concerns and priorities of residents?
     

Project Leverage and Costs
20.	What are the total estimated costs of the project, including the grant funds you are applying for? If there are multiple activities in your project, describe how the costs are determined.
     
21.	What other sources of funding are you using for your project? Describe the dollar amounts and where the funds are coming from.
     
22.	Are the funds in hand at the time of the application, or are they anticipated? Provide a copy of any commitment letters or documents that illustrate the leverage for this project.
     
23.	If you are not awarded this grant, how will your project change (i.e., will you pursue other funding sources, will you eliminate a portion of the project, etc.)?
     

Project Assessment
24.	How have the costs of the project been determined? Describe who has been involved with determining the costs of the project. Include a copy of any assessments or bids that have been completed.
     
25.	What is the timeline for the project? Describe when you expect the work to begin and when you anticipate the work being completed. Include any documentation or Gantt charts that illustrate the project timeline.
     

Project Experience
26.	Describe the experience of any contractors, appraisers, engineer or consultants (etc.) selected for this project. Include any applicable licenses or certifications that are needed by the parties involved in order to complete the project.
     

27.	Describe how and why the contractor, appraiser, engineer or consultant (etc.) was selected for this project:
     

NOTE:  Applicants must also submit the application checklist and all supporting documentation listed on the checklist.

Application Checklist 	
	Application Narrative and Required Supporting Documentation (this Document)	
	Applicant Signature Page	
	Entity Informed Consent Form	
	Project Cost Assessment Documents	
	Construction or Acquisition Timeline	
	Credit Review Documents 	
	Department of Health Inspection Report 	
	Park Owner License 	
	Rent Rolls	
	Photographs and/or Ariel Map of the Park (optional)	
Additional Checklist Items if the Project Includes a Park Acquisition 	
	Commitment Letter	
	Purchase Contract	
	Appraisal