Design Assistance Request Form
for Main Street Iowa designated communities
Project Information
* Required
Main Street District:
*
Albia
Ames
Avoca
Bloomfield
Boone
Burlington
Cedar Falls
Cedar Rapids - Czech Village New Bohemia
Centerville
Central City
Chariton
Charles City
Clarence
Colfax
Conrad
Coon Rapids
Corning
Davenport - Hilltop Campus Village
Des Moines - 6th Avenue Corridor
Dubuque
Elkader
Fairfield
Fort Dodge
Greenfield
Grundy Center
Guthrie Center
Hampton
Iowa Falls
Jefferson
Indianola
Keokuk
Lansing
Manning
Marion
Marshalltown
Mason City
Monticello
Mount Pleasant
Mount Vernon
Nevada
Newton
Osceola
Oskaloosa
Ottumwa
Sac City
Spencer
State Center
Story City
Washington
Waterloo
Waverly
West Branch
West Des Moines - Historic Valley Junction
West Union
Woodbine
Who is completing this form?
*
Building Owner
Business Owner
Main Street Executive Director
Other
Preferred Visit Type:
*
On Site
Virtual
Not 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:
/
Month
/
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Budget:
*
Rows
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 Grant
Main Street Iowa Challenge Grant
Historic Preservation Tax Credits
CDBG Upper Story Conversion Program
CDBG Downtown Revitalization Fund
Other
Upload current photograph(s) of the property that best supports your project type (high resolution only)
*
Browse Files
jpg, jpeg, png, gif only
Cancel
of
Have you consulted with the Local Main Street Executive Director about Design Assistance for this project?
*
Yes
No
Email: (Main Street Executive Director)
*
Confirmation Email
example@example.com
Building & Business Information
*Required
Building Information:
*
Rows
Response
Building Name
Building Address
Year Constructed
Name of Building Owner
Email Address
Is the building located in a local Historic District or listed on the National Register of Historic Places?
Yes
No
Upload historic photograph(s) (if available)
Browse Files
pdf, doc, docx, xls, xlsx, csv, txt, rtf, html, zip, mp3, wma, mpg, flv, avi, jpg, jpeg, png, gif only
Cancel
of
Business Information:
Rows
Response
Business Name(s)
Business Type(s)
Name of Business Owner
Email Address
Upload business logo (if applicable)
Browse Files
jpg, jpeg, png, gif only
Cancel
of
Submit
Print Form
Should be Empty: