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HomeMy WebLinkAboutSWP272711(4) THE CITY OF RENTON DEPARTMENT OF -_ PLANNING/B i DING/PUB IC WORKS RKS FOURTH FLOOR 200 MILL AVENUE SOUTH RENTON, WASHINGTON 98055-2189 _ FAX: 235-2541 To: Company: Phone: Fax: Company: Phone: Fax: Date: ��%�y 7 Pages including this cover page: Comments: Arr/,C4f!.o M 11 1� r!�2 OM I�Nro d V1LL N 93,4 St Fug aIAr /Ru, nJ , fLI(A sC Ga-t- l F (-/u I, /-) 4v&.5'jk)�, s 4.tz lea- 2,1011 7 i FED 12 '97 11!01 nm nT3,T 9015PF P•1•'7 Central Puget Sound Economic Development District 219 First Avenue 5„Suite 305 •Seattle,WA 98101 • td: (206)623-2744 •Fax: (206)623 2747 FAX TRANSMITTAL SHEET DATE: O: Ri7Yl 57raka- FAX NO.: COMPANY NAME: C1+ o FROM: C Luc k FAX NO.: (206)623-2747 NO. OF PAGES: MESSAGES- YL , / S Le e Zriai USc n jCd vY ca,&�' 3 -a7W Senviaq Xijw Xitsap 'Pierce Cv Snohomish FEE 12 '97 11'32nm nT&T 9015PF P.2•,7 FORM ED-9o0P OMH Approval No.0610.009[ Approval Ucpir=12-31.96 ECONOMIC DEVELOPMENT ADMINISTRATION PROPOSAL FOR FEDERAL ASSISTANCE ::Public teportMg bUlde t fi :ilua•iwtlowuu�f aa6ori aois is dtims �s avciago 3 hauls fie!>;+ap0 '.:..' u�cludi>,gt�e�nme€oo;r�elvlea,;searchiag d�sanates;;8afhcnagrand rnainourring dau nodr� alb .:; colYipltttls):a> rcvie the soitecn of idea Seca`commcacs regacdmg tt�i.txaJcu a�uam ua:indigg:suggesvonti fvr zcd[cing�>�den.w:: t3eocomic Drtiblopmeoc•Adm�a+sisaaoa, :•.H�Ibert C Hoover Buddul �iiAs��n D,� Zo230 and:to t6t.uftice o1 .1lliotmattoa Re�ulatory Ah'atzs .Duce of.Managcmcot.aaf�eulgcr W ' D.C. The purpose of this Proposal form is to obtain information which will be used by the Economic Development Administration (LDA) to evaluate a request for Federal assistance under any EDA program. If the proposal meets statutory, regulatory and evaluation criteria, the proponent may be invited to submit an application. An application, is a serious undertaking which will involve significant staff time and perhaps coordination with other lvc;W, state dud Federal agencies and may involve cngineering and legal services which may not be eligible for reimburxtnent with grant funds. Additional information and documentation required may include applicant and project benerwiary certifications of compliance with federal goals of civil rights and environmental protection, and EDA's uu=location cequiremeuts. If the project is approved, a financial assistance award will be made. Acceptance/affumatiuu of the award signifies agreement to implemew the project in accordance with all terns and conditions. Failure to comply with any term and/or condition may result in termination of the award and forfeiture of award fonds. Please answer all questions completely and accurately. Be concise, using the space provided, with additional sheets, only if nece.seary. Copies of studies or reports, should be Included only if reyumied by an EDA official. An original and two copies should be submitted to the Economic Development Representative (EDR) identified below who will explain EI)A Programs and requirements, and provide advice and assistanc:c in identifying and resolving critical issues. (Name) (Address) (nooc No.) Du Nut Include This Page Wirli The Conrplered.,ippllcarion FEB 12 '97 11=©2nm nT&T 9015PF P,B•'7 l ' � THIS PAGE INTENTIONALLY BLANK FEB 12 '97 11'©3f m nT&T 901SPF" P•4•'7 ( FIGURE I Standard Form 424 APPLICATION FOR 0MS AWrwW W.034&404 FEDERAL ASSISTANCE "°0'=f0w=ff l.'MM OF SUMMON; • 1 D&a RECE YW WT STATE 5=A�e�1 kIPF?eer Aedineon • Prslcd nw ❑ Con=coon 0 0QM7<tjon L OM FWEM In FEDERAL AM= F�dgf71 f>rteer ❑ Nwzt)ntmttOn O Ner.l�n�rrtrrir�n i.APPL!.AN T INFORYATON LOW Nair: Upommmm Un¢ Aegis&m Mc=ws sstL sus swv peow sm mapvr m mar er o�n of mrtoo on maws rr+.a..y rro C aOLam cmTKICJTIOK WMM IEM fanv AS>orGP•aR rar^Gaq FT B.CaaeY 1. 3m COMM main of t fiw— LMF* L rM CF A PIMUCATION' C.MAIM* J. Pnoss Urrmrmw ❑w. Tees O Caysaben Q Arm Tsr� K 4bae E e+Msas L. hmmmiuM G. 1 LL omkogarcmon ❑ C.So*"Gana N, Os+r(Sbo*) e Frxson,ansr aar•�r►.c�Rq a+eoaacrlEl L r+ewaa•.W6 8_ ocerw 404" C.sow Omen D.D�Dwamn Oww(Wmp/F L HOAR OF PEXPAL A0089t. tL aA7AA AO Or FOALOOYE.iMASOWPAMMKWML, :t. 4dl�TlVG�115OCAcolt I��OJ�t: TIRE: IL M FAA 2 AFFTICCTGO 1T PM0JWT fCbeL Ce01eL SUM.0104: Tl PIe0F+o m PROJECT iL COMOMENSIOMAL 05TRCP5 OF: Sart Om Enmv OEM a- AOOleere a Pico= 1a.RITYATED imom: u. B APPUCAMOK 9UY.BT TD 094IN If SUM i CVM4 OIOM i Ferry i w �7lt2PY0Gi449 I t'E5.Tmts PREAwucxr ON/ApK=xrpN mLs WICE AIPtL1►6lA e.Aeotiae■ s q0 TO TT$STATE VXCU VE CFMR IZM fail F EvIFw OK: e s m DATE �.►� s m e wo f7 vaocaau a Fi7T c�S+EAED eT EO.tZSTZ 3 AO p OR PFMpAm mm MOT sM 3Mj-•7W BY STATE FCA FiEV ell 1, FFWX warns a D7 17.A THE APPL><Al T WJlfZAPfr oN hW PlOUAL=MT1 q.TOTAL s .00 O Tat !lime sarr sn emwwwL 0 me 7A.?a ng 2WY or U9 musowLEDm AND RELAF ALL UTA W TWq ADDLrATfOrARE►gaMir om Ans TSRR Am m/sT,Tit DO1CLIMIT Hku � WL7&VTW0lV=WY rrM GOWCA oaC 9WT OF TM APPUCLNT AND TM APPLICANT W4L COWLY twlT4 TTi AT7%CMV ANSLOAMM IF T1i AttDTaNM d AWAPW=. i Typ go a d AuforaW Wewsee+efw e_Ties a Tswom le MOW Q Seraaro of AvDv¢r♦e Werwruiq.e ••Iw Song P� ATaw urn. l..ra M Ht(M"m A mw m w Lam qsw. Aatsr or go CY.w"at 3 FEB 12 '97 11!a3nm f1T&T 9015PF P.5•,7 '. FILURE 1 (Continued) Standard Form 424 INSTRUCTIONS FOR THE SF 424 Public reporting burden for this colleatiort of information is estunaied to avenge 45 minutes per respo ise, including time.for reviewing instructions, starching existing dam sources.gathering and maintaining the data needed,and compleung and reviewing=ca►lecuon of tntormauon.Send commmis regumng ire Wrdert esttrttate or any other;saber of this collectim of information, including su&Sesaons for reducing this burden, Ia the Office of Management and Budget. Paperwork Reduction Project(034-00a3),wasningon.DC 20503, PLWIE DO NOT RI~i`URN YOUR COMPLETED FORM TO THE OMCE OF MANAGEMENT AND RUDGET, SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY. This is a candard form used by applicants as a required fa=hev fnr fxrapplicatirng and applidtinns submitted for Federal asaist,uwx-It will be used by Federal agencies to obtain appl,"IL t ati&6auutt that States which havn csablisb-i a stview and comment pturedum in regwnce to Execurive Orrier 12372 and have.splecied the program to be included in dnar process,have btert given an opporouuty w ruyirw the appiicatu's subttiLwon. ltctrt: Entry Iu=: Entry: I_ Self-expianatory. 12. Let only Utc tar=political entices affected(e g..Start. 2_ Date applicuion submitted to Federal agency(or State if couauca,clues). 'applicable)&apptitant's con==number(if applicable). 13. Self-cxplanatnry. 3. Swe use only(if applicable). 14, Liu the applicaat's Congeszjonal Discriu and any 4. if this appli,— a is to continue or revise an existing Dtmut(s)affeemd by tine program or project_ award,utter present Federal identifier number Tf fnr a 15. Arnouwt requesEed or u)be wotribuwa dtaiag the rust new projlxL leave blanL funding/budget period by each eotnzibwff Vitlue of in- 5. Ltg:W name of applicam name of primary onanau=a1 kind ccoutbutiou sbouid be mchided on appruprivie liter unit which will undertake the ttsaisttutec acuvity,complete as applicable.If the action will gestalt at a dolls change to address of ere applrczttL and name an0 telephone number an eztuing aware,indicate ac�Lttee a wont of ur dmge, of the person to aontoct on maum rclu, to this For decreases.enclose the amounts to pwwutlmanc.If botb application. beat and S=lementai arnOurAS are cnCloW Scow btraitdawn on an auaehed shut_For muLupie program 6_ Enter Employer Identification Number(EIN)as assigned funding,use rnm1c and show hrmkdown using same by tine Inierrial Kevmue Service. attgonts as item IS. 7. 'F1tter the appMrinta letter in the spece provided lh applicanu should contact the State Single Pieter of 8. Chwx appropr=box aria eruer appropriate letter(s)in Contact(SPW for Federal Euattive Order 12372 to the spwe(s)provided: dtttsrMna WhUbAf the spplitstioe is Subject to tbs Sous inirrgovttnmenial review ptoce� — "New"mtmrzs a new assistanceawatC. 17. This question applies to this appiicatu orgnrtization,not — 'Y_'oncinttatian'means an e:tertpon for an addiriona► trle pets�pn who 57>?ris as the autila[Zted tept[G9CnrarlYe. completion puled for a prpjeet with a projected Camgcuits of debt include deliraxot audit dis9Wvzi es, mptetion dare. Inns and la:ec. "RerisitJrr"rnewS any change in the Fedmul Government's ftrwrial obligation or contingent 18. TO be signal by the audxximd rtprestzinove of the liability from an existing obligation. appiicartt A copy of the governing body'sautb�ien v. Name of Ftiaeral agency from wnica AniQAnr r is being for you io sign tail applicatlan as ofricfai represmpave must be on rile at dbe,appiicmt's ofite.(Cermin Federal requeaed with this appligtioa acenetes mey tontine trier irtis atr[Oorimntut Oe srOcmQeG 10. Use the Catalog of I'crderal Dofr emk Ami%an¢e number pare of the asppLicntio n.) aria title of Ute program tu10es which assistance is requested. 11. F1uer a brief descriptive ude of tine pro)ccL If more than one program is Involver!,you should append an explanation on a yeparauo shut_If appfopriatt corutrumon or reel moperty prop=).mach a map showing project location.For pssapplirarions,use a separatt snot to txovtde a summary description of d3il pro)CL SF Qs BaM(Fw,*?21 4 FED 12 '97 11'G4nm nT&T 9315PF P.5•'7 Project Description: Briefly rleccrihe components of the project. For constmCtton pro*ts, attach a topographic trap showing Me location of the project. Propnnent'c Csipahility: Briefly describe the proponeut's Capability to administer, implement, and market the project. Explain when me project can be implemented. Problem: Bricily dcscribc the severity of the problems that are adverscly affecting economic development in the Community and how the project will address the problems and complement the cotttmtmity's plain iIlg prncecc: Project Impact: Briefly describe the expected impacts from the project and how unttnpinyed,underemployed and dislocated workers will benefit from the project. Project Beneficiaries: Identify employers who will benefit from the project: Company Name&Products Jobs Saved New Jobs Private 5mwr Committed ur lnvcn=t$ Interest Only Clvll Rlgh6 Issues: If the prgmncnt and/ur cwpluycts ideadfied above, have beta the subject of any uwesolvcd issues, or negative determi =ons issued within the past two years, arising from civil rights compliance reviews, complaints, lawsuits or other allrgatinn.c of diccriminatitm on the basis of race, color.national origin. sex. disability or age,briefly describe the issue(s)and stams thereof. 5 FEB 12 '97 11:04nm nT&T 9015PF P.7,,7 .Funding: Constmwd n project Dude rub- to Nonxonstroctim Project Budget rAhm to gLminisafrive F�ense: Personnel Laa4 Struca=s,ROW,Easemeaa Friar Befletits Relocation&tneidesesl Coca to Acquisition Travel A/E Feed a.Inepecaon EV7— Cowavaaoo.Demoliaoa h Equipasont Supplies Conaaacociu Cona%caual Coaem,caon Othor Tool Diroct Cbargcs ludircit Charges Tons!Pmjczc Cosi Tool Project Con Identify sources of non-KDA funding: Tlde/OwnessWp/Ope adon and Maintenance: (Cuns mction prujecb) 1. Will the facilities funded by EDA be owned, operated and/or maintained by an entity other than the proponent? If yes, ideatify. 2. Will the real property to be improved or the facilities funded by FDA be mortgaged or used as collateral for any financing and/or is any real property to be used for this project currently mortgaged or being used for collateral? If yes, explain. 3. If the facilities fwmded by EDA will include acquisition, construction. or iTnprovemem of a building or acquisition or improveme-m of significant items of tangible personal property, can the propu nem provide a security interest to EDA? If no, explain. Environmental Issues: If yet to any quarriont below, briefly ezplmn. L J NIA L J YES L J NO Will Me project be located in or adjacent to a tloodpiam or wetland area? [] NIA [] YES [] NO Will the project be located in or adjacerut to an area with known hazardous or torte contamination? [] N/A[] YES [] NO will there be any tone or hazardous waste, or asbestos associated with this project or employers bencfildag from this project? [] N/A[] YES I] NO Will Lhc prujcct impacu any dn:4wlogit2l saes,buildings, or struca=older than 50 year5, or auy properties listed on, or eligible for the National Register of Historic Places? [] N/A[] YES [] NO Will tltis pruja:t resurlt W auy other adver5c envirtruuremtal impacts which would affect endangered ar threatened species, scenic rivers, or other sensitive ecological habitats? 6 ,1 FOPA.1 ED-900P OMB Approval No.0610-0094 Approval Expires 12 1-96 ECONOMIC DEVELOPMENT ADMINISTRATION PROPOSAL FOR FEDERAL ASSISTANCE Public zeporting:burdenf, this collection of information is estimated to average 8 houis per response; inciudzng the lone:for review, searching data sources, gathering and maintatmng rtata needed, and completing and reviewing the collection of information. !send comments regaz a this'burden estntate,�rciudmg suggestions for reducing ties buzden,to: Economic DeveIopmentAdminsrration HeFbert G :Hdavez Batidtng washngton i�.C. M234, and to:the Dffice of:information and Reguia#ory Affas OfSice f Managementand Budget,Washington;D C 2a5ti3 The purpose of this Proposal form is to obtain information which will be used by the Economic Development Administration (EDA) to evaluate a request for Federal assistance under any EDA program. If the proposal meets statutory, regulatory and evaluation criteria, the proponent may be invited to submit an application. An application is a serious undertaking which will involve significant staff time and perhaps coordination with other local, state and Federal agencies and may involve engineering and legal services which may not be eligible for reimbursement with grant funds. Additional information and documentation required may include applicant and project beneficiary certifications of compliance with Federal goals of civil rights and environmental protection, and EDA's nonrelocation requirements. If the project is approved, a financial assistance award will be made. Acceptance/affirmation of the award signifies agreement to implement the project in accordance with all terms and conditions. Failure to comply with any term and/or condition may result in termination of the award and forfeiture of award funds. Please answer all questions completely and accurately. Be concise, using the space provided, with additional sheets, only if necessary. Copies of studies or reports, should be included only if requested by an EDA official. An original and two copies should be submitted to the Economic Development Representative (EDR) identified below who will explain EDA programs and requirements, and provide advice and assistance in identifying and resolving critical issues. KING KITSAP PIERCE SNOHOMISH (206)623-2744 (206)623-2747 Fax _ Bill Huntington _ Program Specialist CENTRAL, PUGET SOUND ECONOMIC DEVELOPMENT DISTRICT New England Bldg.,Suite 305,219 First Ave.S.,Seattle,WA 98104 Do Not Include This Page With The Completed Application FIGURE 1 Standard Form 424 APPLICATION FOR OMB Approval No.0348-0043 FEDERAL ASSISTANCE 2DATE SUBMMIED Applicant Identifier 1.TYPE OF SUBMISSION: 3.DATE RECEIVED BY STATE State Application Identifier Application Preapplication ❑ Construction ❑ Construction 4.DATE RECEIVED BY FEDERAL AGENCY Federal identifier ❑ Non-Construction ❑ Non-Construction 5 APPLICANT INFORMATION Legal Name: Organirzational Unit Address(7w city.—L-ty state.andzp=do): Name and telephone number of Person to be contacted on matters invoivirtg this application(vne area—1 6.EMPLOYER IDENTIFICATION NUMBER(EUM: 7.TYPE OF APPLICANT:(enter appropriate letterm box) ❑ A.State H. Independent School Dist E.County I. State Controlled Institution of Higher Learning 8.TYPE OF APPLICATION: C.Municipal J. Private University ❑ New Q Continuation Q Revmon D.Township K. Indian Tribe E.Interstate L. Individual R Intermuniapal M. Profit Organization a F7 G.Special District N. Other(Specify) If Revision.enter appropriate leuer(s)in box(es) A-Increase Award E. Decrease Award C-ktcrease Dtrranort D.Decrease Durauon Other(specityt 9.NAME OF FEDERAL AGENCY: 10- CATALOG OF FEDERAL DOMESTIC ASSISTANCE NUMBER: 11. DESCRIPTfVETTTLE OF APPLICANTS PROJECT: TITLE: 12 AREAS AFFECTED BY PROJECT (Cities.Couts6es.States.e(c): 13. PROPOSED PROJECT 14-CONGRESSIONAL DISTRICT''OF: Start Date Ending Date a. Applicant b Project is.ESTIMATED FUNDING: 16. IS APPLICATION SUBJECT TO REVIEW BY STATE EXECUTIVE ORDER a.Federal b 00 72372 PROCESS? a YES.THIS PREAPPLICATIOWAPPLICATION WAS MADE AVAILABLE b.Applicant S 00 TO THE STATE EXECUTIVE ORDER 12372 PROCESS FOR REVIEW ON: c-State S 00 DATE d.Local b .00 b. NO. ❑ PROGRAM IS NOT COVERED BY E_O.12372 e.Other b .00 0 OR PROGRAM HAS NOT BEEN SELECTED BY STATE FOR REVIEW f. Program Inmme S .00 17- IS THE APPLICANT DELMIOLIENT ON ANY FEDERAL DEBT? g.TOTAL $ .00 ❑Yes It Yes'attach an expianta=m 0 No 18.TO THE BEST OF MY KNOWLEDGE AND BELIEF ALL DATA IN THIS APPLICATIONtPREAPPUCATTON ARE TRUE AND CORRECT,THE DOCUMENT HAS BEEN DULY AUTHORIZED BY THE GOVERNING BODY OF THE APPLICANT AND THE APPLICANT WILL COMPLY WITH THE ATTACHED ASSURANCES IF THE ASSISTANCE IS AWARDED_ a.Type Name of Authored Representative b.Tale c.Telephone Number d.Signature of Authonzed Representaive e. Dale Signed I Ptevroua Eda+on Uaatrte Stanoard Form 424(REV 4-9Z Autnor=W for Local Reproduction Reactibad by OM CirpNer A-1Q2 3 FIGURE I (Continued) Standard Form 424 INSTRUCTIONS FOR THE SF 424 Public reporting burden for this collection of information is estimated to average 45 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget. Paperwork Reduction Project(03,48-0043),Washington,DC 20503. PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUDGET, SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY. This is a standard form used by applicants as a required facesheet for preapplicadons and applications submitted for Federal assistance_It will be used by Federal agencies to obtain applicant certification that States which have established a review and comment procedure in response to Executive Order 12372 and have selected the program to be included in their process,have been given an opportunity to review the applicant's submission_ Item: Entry: Item: Entry. 1. Self-explanatory_ 12. List only the largest political entities affected(e.g.,State, 2. Date application submitted to Federal agency(or State if counties,cities). applicable)&applicant's control number(if applicable). 13. Self-explanatory. 3. State use only(if applicable)_ 14. List the applicant's Congressional District and any 4. If this application is to continue or revise an existing District(s)affected by the program or project_ award,enter present Federal identifier number.If for a 15. Amount requested or to be contributed during the first new project,leave blank. funding/budget period by each contributor. Value of in- 5. Legal name of applicant,name of primary organizational kind contributions should be included on appropriate lines unit which will undertake the assistance activity,complete as applicable.If the action will result in a dollar change to address of the applicant,and name and telephone number an existing award,indicate Q[t.(kthe amount of the change. of the person to contact on matters related to this For decreases,enclose the amounts in parentheses.If both application. basic and supplemental amounts are included,show breakdown on an attached sheet.For multiple program 6. Enter Employer Identification Number(EW)as assigned funding,use totals and show breakdown using same by the Internal Revenue Service. categories as item 15. 7. Enter the appropriate letter in the space provided. 16. Applicants should contact the State Single Point of 8. Check appropriate box and enter appropriate letter(s)in Contact(SPOC)for Federal Executive Order 12372 to the space(s)provided: determine whether the application is subject to the State — "New"means a new assistance award. intergovernmental review process. 17. This question applies to the applicant organization,not fund— "Continuation"means an extension for an additional the person who signs as the authorized representative. completion der period for a project with a projected Categories of debt include delinquent audit disallowances, completion date. loans and taxes. — "Revision"means any change in the Federal 18. To be signed b the authorized Government's financial obligation or contingent b'n Y representative of the liability from an existing obligation. applicant.A copy of the governing body's authorization for you to sign this application as official representative 9. Name of Federal agency from which assistance is being must be on file in the applicant's office.(Certain Federal requested with this application. agencies may require that this authorization be submitted 10. Use the Catalog of Federal Domestic Assistance number as pan of the application.) and title of the program under which assistance is requested. 11. Enter a brief descriptive title of the project If more than one program is involved,you should append an explanation on a separate sheet If appropriate(e.g., construction or real property projects),attach a map showing project location. For preapplications,use a separate sheet to provide a summary description of this project SF 424 Back(Rev.4-92) 4 Project Description: Briefly describe components of the project. For construction projects, attach a topographic map showing the location of the project. Proponent's Capability: Briefly describe the proponent's capability to administer, implement, and market the project. Explain when the project can be implemented. Problem: Briefly describe the severity of the problems that are adversely affecting economic development in the community and how the project will address the problems and complement the community's planning process. Project Impact: Briefly describe the expected impacts from the project and how unemployed, underemployed and dislocated workers will benefit from the project. Project Beneficiaries: Identify employers who will benefit from the project: Company Name &Products Jobs Saved New Jobs Private Sector Committed or Investment $ Interest Only Civil Rights Issues: If the proponent and/or employers identified above, have been the subject of any unresolved issues, or negative determinations issued within the past two years, arising from civil rights compliance reviews, complaints, lawsuits or other allegations of discrimination on the basis of race, color, national origin, sex, disability or age, briefly describe the issue(s) and status thereof. 5 Funding: Construction Project Budget Estimate Non-Construction Project Budget Estimate Administrative Expenses Personnel Land, Structures, ROW, Easements Fringe Benefits Relocation&Incidental Costs to Acquisition Travel A/E Fees&Inspection Equipment Construction, Demolition&Equipment Supplies Contingencies Contractural Construction Other Total Direct Charges Indirect Charges Total Project Cost Total Project Cost Identify sources of non-EDA funding: Title/Ownership/Operation and Maintenance: (Construction projects) 1. Will the facilities funded by EDA be owned, operated and/or maintained by an entity other than the proponent? If yes, identify. 2. Will the real property to be improved or the facilities funded by EDA be mortgaged or used as collateral for any financing and/or is any real property to be used for this project currently mortgaged or being used for collateral? If yes, explain. 3. If the facilities funded by EDA will include acquisition, construction, or improvement of a building or acquisition or improvement of significant items of tangible personal property, can the proponent provide a security interest to EDA? If no, explain. Environmental Issues: If yes to any questions below, briefly explain. [ ] N/A [) YES [] NO Will the project be located in or adjacent to a floodplain or wetland area? [] N/A [) YES [ ] NO Will the project be located in or adjacent to an area with known hazardous or toxic contamination? [ ] N/A [ ] YES [ ] NO Will there be any toxic or hazardous waste, or asbestos associated with this project or employers benefitting from this project? [ ] N/A [ ] YES [ ] NO Will the project impact any archeological sites, buildings, or structures older than 50 years, or any properties listed on, or eligible for the National Register of Historic Places? [ ] N/A [ ] YES [ ] NO Will this project result in any other adverse environmental impacts which would affect endangered or threatened species, scenic rivers, or other sensitive ecological habitats? 6 71 A M aT&7 �301_� FIGURE 1 Standard Form 424 APPUCATION FOR OUSA°0f VW PiM aUS-40 3 FEDERAL ASSISTANCE 30 117 Jug 1 ryE 09 6 � � TM OP 3UZMNwKXc 2.om ttwtm n STD sat AiO-cam 10.+•i.r i AM=Mm . a%Q=w"t1Qn C�ntKnrsnrt ' :antm,e++on L n+aL wmvm BY PEWUL AQMcT (ray i.v�vr�xT ueo��urton sty or Snc zhomisn apmu'uUm unlic Worxs j..cvi rw...R.�.w a..+r. 116 Union Avenue Snohomish, WA 98290 Mick Monken-360-568-3115 �1 710 1 01 O C I 7 8 H•:fOW I. MwCawam noLum oil laufertfl L T7K;i 41PPUCATION: C.M4.>a. 1 Pr•�Uw�w tree 0.Taw.np XQ N.. C C-20OXaMCM 0 PAVOwn wVm E r.rstaa L L Wnr�ow F 1 1L P-M 019va rre Q.S.w»Dona N. orw(so-ty) lk:re.vf.�wt awser el4fRS1 n bq�f jI.►L`K+ M�iE �. caw-ANN. 0- ` o.tSr,na<re G,an.+ Ut+�r rsa.drx a wru of POMRAL nWC1' Economic Development Admin. f t a caL::GG ci i�iDiASL DOI�i?1C Ji�ZaMG� ,:. DOW VTlYETTsli Oc u�f llct'a v110�T 1 1 - Swifty Creek/Avenue A ten: Storm Culvert Repair- tz Ae[Ats.►ATW. VNtOJW7 tarw csrs sws Mcr City A. 0acucrr to R71501 aartecrs Co. Stetom IEnreyDw tIIL �orss*i p 1 n/a 6 1 /9 7 I Twn Two ti QTWTm PUNOrec: Si s ATM stJaAU"O NVM SY omm" t11TSrpCi9!! 39 , 367 r> 'HestE►r*ttlT�awrr�tr�onoN Mns 1i1�CE waaAa.E FCP L A.reo.• -7s 13 , 123 REvW r awsE icts o�t�i 3s i c sa. s ao aTE iatmr Its m Ii I �. i+o. D w1dGlMrt is K7T cONU��r E,0.�?SYZ L 00W s m C On ntOGPAM etias MUr BMW===BY Sfi7f Pat FEYP" 4 I. Aep n nwmw 13 TT.JS7WAMU=WTDdilLWfCNAW"KW1 Ll'�Tf y.Tt�fAL I S m C Ym tt-Tft.-now ie 4mm w'- Q H. 52 , 490 1L ro THE 90T oc KY KNOWUU rd Alm 9UXF All 211A I I AJI=MXM AM TOM AM CDt011C T!E 7cJGAOW K"i @I=GNLY ttr ra atatlt"M go=a Tf APPU=W AW TW APPl.CM T Wa:COOKY WM IM/47iC M LSill MCO tF 7W ASMWMM t ss AWZ==- i a Trw N.+M d orrowmre a.r�.�w L..%w C T.we.�garwr Mick Monken� Director of Public Wor s 360-568-31A •-ow s,rno I ILL 10 '% 02:2 7V AT&T %15PF P.51,7 FIGURE I (Continued) Standard Form 424 INSTRUCTIONS FOR THE SF 424 Pubii:reporting burden for thu colkeuort of information is esumam to averW 45 mmums pa response, includiag tame for reviewutg =u-ticucns. senmtuxg existing data sours u, gatttermg and maintaining the data needed.and compietaag and reviewing the collection of infos'rnation.Send comments m-garding me ouroczi auntue or any other am=of vus coliec~uon of information, including sugscstions nor reducing this burden, to uie Office of Management and Budge. Pirperwesrit Reaucuon Project(0348-a93).washmgm,DC W-IM, PLEASE DO NOT aMRN YOUR COMPLETED FORM TO THE OFFICE OF MANAG"hMNT AND BUDGET: SEND ITTO'THE ADDRESS PROVIDED BY THESPONSORING AGENCY. This is a standard form used by applicants as a repwred facesbw for pneappiicwors anti appiirumm submitted for Federal xenuvMr It will be used by Federal age==to obtain apiie:ant cerdfiatton that States which have estabLvied a review tied caesmart procca=m response zo Exacizu a Order ITT'and have xleczed the program to be iacludw in thaw process.have been given sa opporatmty to revww the apOieant's sn-bmLuux)n leant: Envy: item: Easy: 1. Self-explanatory. 12. L=only the largest poluxal entities affected(e.g-State. 2. Date application sutsm taw to Federal agency(or State if cow.sues). amixabie)&applicant's:==I M=bm(if applicsaie). ,I. Scif-exptan=ory. �. Stuc use only cif appll=ue). 14. l �n the appiirsat's Congrewaoral Dismu sad any 4. if Thu appitcawn is to coaaaue or revise an etdstmtg Duzr=2(s)affsced by tare protram o:worm award,enter present Fesarraf idemifia ma nbe.If for a K Amount requested or=be ccatrsb end.darmg the first ref"proms leave bhnlr fuaditngPot et;- . I by atilt c i ara9bamr Value of in- 5- Legal Time of appiicam Tam of prrruary*Vn=uooai kind cartuibuum sbtxnd be isac:uded c n lines unit which will and crane toe--rter autvity,coami to as=piirsble.If the action Will result in a dollar garage to address of the applicant.and name and telephone mamba an muting award.ind=, =j ttx amount cf the ch=V. of the person to contact on natters relined to this For decreases_ttclnse we amowu in parentheses.Uboth amiitatton. basic Steil uMlcnentai amount ate included.show 6. Enna Employer Wen rmurtm Number a24)as assigned brenicdown on an—matted shm For mWupie pmptm by the lntaral Revenue Service. funding,use totau and show mukdowa U=S same Q=gones as hear 15. 1. Enter tine:mmprmte teen in tare space peovided. '6. AgStcams sh uld cantata the State Single Point of 5. Check approprsate box and cn=approortase ietuw(s)in Con&=fSPCCi far Feoc al Esecsasve Order 1=14 to the spice(s)pipYtdO� detCJSnine urtiettnG he IjNitCitTOA iS staD�Ct to the State im ajoveran)emal review procim .fVe,r-meem a new aurtanae await!. Contua:cstiort"me:uts an extczwan for;=additicesal ' This quitstion applies to the applar—aTantm ion.not futtttittg/bubgtt period for a pt+ojeu with a Ftro� cite paean Who gas as the arstboraad repr> ve. fuza l bu date. Campnes of debt iadude deimawnt audit disauori►aq= comloans ana razes — "Revision"ratans any cnaag m une Federal ;8. To be signed by the ate xtized mpraestative of the Governmo+z's f aancnal ablipzm or connngnt Liability from an existing obiiptian. aDDlicapu A any of setae gvvermg body's atuhortzuiaa for you to sign this applirsnrioa as cffi—i rave 4. Frame of Federal agency fmn whist assistance is besng mutt be on file=sax r�eauested with this applisauoa, ap}�iicat¢t's office.(Certain Federal agencies may require tf u tins audxz=ucm be 10. Use the Catalog of Federal Darraessic Assn==number as dart of the applirsuon.) mad title of the propitm sander which asiisia=is 11. En=a brief desaTpuve auk of ttae prvpa.if snore than one ptvgrun is involved,you should wpend an wmLananon an a separate sisea>r if appeopnm(e.g_ construction or rest property gmje ts).attach a reap stw.rmg pro)=location.Fcr peeappiicuions.use a separate shoo to provide a storrtary dent ;Km of this P o)ect. sF 4N east(tiw.�&4m 4 Project Description: This proposed project is to install a 24 inch diameter pipe inside an existing 30 inch culvert,which was damaged due to flooding of the Snohomish River this past February, for the entire length of 220 feet. Riverbank repair and"armoring"would be performed to protect against further erosion. A topography map and schematic layout of this project is included with this application.. Proponent's Capability: The City has an Engineering division which has a License Engineer on staff with experience in design,project management, implementation of a construction project, and public relations. The City also has field staff for inspection and field supervision during the construction phase of this project. It would be the proposal of the City that this project would be implemented as soon as funding is available. Problem: Due to erosion of the riverbank, along the Snohomish River, some sections of a 30 inch diameter clav culvert were lost. In addition, when the culvert was disturbed, it appears to have caused damage to a section of the pipe remaining in the river bank. There now exists a steep slope bank,near vertical for 15 feet, with a damaged culvert in the bank with poor access to make repairs. The damage has reduced the cross section area of the pipe. The culvert has a peak flow of about 750 gallons per minute. The pipe is an old red clay pipe and is located under a section of public road and under the-outside wall of a business office. The problem is if the damage section of pipe collapses, a large section of bank will be lost. In addition, damage or lost to business properties could result. Project Impacts: This project will help to preserve employment by protecting the business facilities. Project Beneficiaries: Keithly, Weed, and Graaffstra Attorney at Law 8 employees Hubert Associates,Inc. Attorney at Law 3 employees John Rodabaugh Attorney at Law 3 employees New York Life Insurance Insurance 4 employees Thorco/N. Thordarson 2 employees Oxford Tavern Tavern&Diner 8 employees Civil Rights Issues: No Applicable. - Construction Project Budget Estimate Non-Construction Project Budget Estimate Administrative Exi)enses 500 Personnel 0 Land, Structures,ROW, Easements 400 Fringe Benefits 0 Relocation& Incidental Cost for Acq 600 Travel 0 A/E Fee& Inspection 1000 Equipment 0 Construction, Demolition& Equip. 46000 Supplies 0 Contingency 4000 Contractual 0 Construction 0 Other 0 Total Direct Charges 0 Indirect Charges 0 Total Project Cost $52,500.00 Total Project Cost S 0.00 Identify sources of non-EDA funding: Local funding would be through Harbor Funds and Utility Capital Improvement revenue. Title/Ownership/Operation and Maintenance: 1. Will the facilities funded by EDA be owned, operated and/or maintained by an entity other than the proponent? 5 3. If the facilities funded by EDA will include acquisition, construction, or improvement of a building or acquisition or improvement ofsignificant items or tangible personal property, can the proponent provide a security interest to EDA? YES Environmental Issues: NO Will the project be located in or adjacent to a floodplain or wetland area? NO Will the project be located in or adjacent to an area with known hazardous or toxic contamination? NO Will there be any toxic or hazardous waste, or asbestos associated with this project or employers benefiting from this project? NO Will the project impact any archeological sites,buildings,or structures older than 50 years, or any properties listed on, or eligible for the National Register of Historic Places? NO Will this project result in any other adverse environmental impacts which would affect endangered or threatened species,scenic rivers,or other sensitive ecological habitats? 6 We in o Z ol \ m _ o ✓ ../ `n z �Y I` ` x (-rT s .r •,•"r j, ra .s t d z ! i O- X CL In kit SE r z ��~ 151H EVE SE 0 Dm mcl DZy WEAVER 901H E 1 N U WIG RD IMy 9 �J4 b ��� 1 A AV a� 0 � d fir0. f��P:3P 1! 0 o ' o ° dd AVE. N ! o � ✓� V AV �®� AVE. D U O AKA VE. AVE ® R AVE. EI YAN CI $ CD �4 ( � VE. A rC) A D x l=J R70b�fl ]VE Zsm x ALICE 9l RF AIAP � �i ° ROOT CO o LAKEVIEW �_ L -. � � I DY Xl DR FORD Cl YEDROHA P A R K xr- .. .._.. .. �/E. Q PINE ®� LINCOW 2 PULLIAM PL �[I-�^�'I C PwE 9 AVE. tt ' I/lhr -Uy imil ' U mT s PINE71 A Ea k _ MEADOW PL A Q n ( � Ea Iry TERRACEAVE. N .. . 53g Ral Hs4 Ok r O SEXTON DESEL J