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Huron East Accessibility Improvement Program Application Form

To apply to the Huron East Accessibility Improvement Program, please fill out the form.

Section A: Applicant Information

First and Last Name:

Roll Number (#):

Address of Property:

Mailing Address (if different from address of property):

City/Town:

Postal Code:

Phone Number:

Email Address:

What types of improvements are being made to the building? Please check all that apply.

Exterior - ramp, accessible door and/or door opener

Exterior - other

Interior - ramp, elevator

Interior - other

Is the property of historical significance or designated under the Ontario Heritage Act?

Yes

Not Sure

Are you the owner of the property?

Applicant is the owner of the property

Applicant is NOT the owner of the property (please fill out section B)

Section C: Project Details

Project Description:

Please upload any project drawings, renderings and/or photos. Applicants must provide at least one "before" photo.

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Allowed extensions pdf, doc, docx, xls, xlsx, jpg, jpeg, gif, png, tif

Section D: Project Costs

Total Project Cost (not including HST):

Attach Quotes (two quotes are recommended)

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Allowed extensions pdf, doc, docx, xls, xlsx, jpg, jpeg, gif, png, tif

Applicant Contribution Towards the Project (not including HST):

Grant Request:

Grant Request as a Percentage of the Total Project Cost:

Section E: Signature of Applicant

Signature of Applicant

Clear

Date (MM/DD/YYYY)

In accordance with the Municipal Freedom of Information and Privacy Act, personal information is collected under the authority of the Municipal Act, 2001 and will only be used by the Economic Development Department and the Community Improvement Program Committee for Community Improvement Program purposes. Questions about the collection of the personal information may be addressed to the Clerk at the Municipality of Huron East, 72 Main St. S., P.O. Box 610, Seaforth, ON, N0K 1W0 or (519) 527-0160.

Questions related to the Facade Improvement Program are to be directed to:

Municipality of Huron East, c/o Taralyn Cronin, Economic Development Officer

72 Main St. S. Box. 610 Seaforth, ON N0K1W0

519-527-0160 ext. 36

edo@huroneast.com