Design Assistance Request Form

Design Assistance Request Form

for Main Street Iowa designated communities
Project Information

* Required
Main Street District:*
Who is completing this form?*

Building OwnerBusiness OwnerMain Street Executive DirectorOther
Preferred Visit Type:*

On SiteVirtualNot Sure
Main Street Iowa design staff will help determine visit type based on project needs.
Please give a brief description of the proposed property improvements:*

0/500
Proposed Construction Start Date:

MonthDayYear
Date
Budget:*

Estimated Budget Amount

S
Do you plan to use any local programs or funding incentives? If yes, please list.
Do you plan to use any state grant programs or funding incentives? Select all that apply.

Community Catalyst Building Remediation GrantMain Street Iowa Challenge GrantHistoric Preservation Tax CreditsCDBG Upper Story Conversion ProgramCDBG Downtown Revitalization FundOther
Upload current photograph(s) of the property that best supports your project type (high resolution only)*

Browse Files
jpg, jpeg, png, gif only Cancelof
Have you consulted with the Local Main Street Executive Director about Design Assistance for this project?*

YesNo
Email: (Main Street Executive Director) *

Confirmation Emailexample@example.com
Building & Business Information

*Required

	Estimated Budget Amount
S

Building Information:*

Is the building located in a local Historic District or listed on the National Register of Historic Places?

YesNo
Upload historic photograph(s) (if available)

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pdf, doc, docx, xls, xlsx, csv, txt, rtf, html, zip, mp3, wma, mpg, flv, avi, jpg, jpeg, png, gif only Cancelof

Business Information:

Upload business logo (if applicable)

Browse Files
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Should be Empty:

Project Information