Critical Home Repair Application
Thank you for your interest in She Built This City's Critical Home Repair Program. Our program provides free critical home repair services to qualified residents in Mecklenburg County. Our apprentices, who will be performing the repairs, are being trained by professionals who are dedicated to improving the safety and accessibility of your home. Please complete the following application to be considered for our program.
Disclaimer
Before you begin this application, please have digital copies of your recorded deed and your most recent mortgage statement (if applicable) ready to upload. Applications submitted without these documents cannot be reviewed.
Personal Information
Please complete the following information below
Name
First Name
Last Name
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Demographic Information
Date of Birth
-
Month
-
Day
Year
Date
Ethnicity
American Indian or Alaskan Native
Asian
Black or African American
Hispanic or Latino
Native Hawaiian or Other Pacific Islander
White
Other
Gender
Male
Female
Other
Qualifications
limited to homes in Mecklenburg County.
Qualifications
Income at or below 70% Area Median Income
Owner Occupied Primary Residence
Have lived in the home at least 5 years
Current on Mortgage Payments if Applicable
Current on Property Taxes
Plan to remain in home for at least 5 years
This property is located in Mecklenburg County.
True
False
Primary Residence & Ownership Attestation: Deed and mortgage must be in the same homeowner's name
I currently live in this home (owner-occupied).
I am listed on the recorded deed for this property.
I am the borrower on the current mortgage (if any).
Income Documents
Income documentation required for applicant only.
Select Proof of Income Documentation Below
Please Select
SSI Award Letter/Retirement Benefits Statement
Most Recent 2 Months Bank Statements
New Employment Award Letter
Proof of Income
Browse Files
Drag and drop files here
Choose a file
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of
2024 Property Tax Bill
2024 Mecklenburg County Tax Bill
Browse Files
Drag and drop files here
Choose a file
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of
Upload proof of ownership (recorded deed)
Browse Files
Drag and drop files here
Choose a file
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of
I authorize SBTC to retrieve my deed from the Registrar of Deeds.
I authorize SBTC to retrieve my deed from the Registrar of Deeds.
Upload current mortgage statement
Browse Files
Drag and drop files here
Choose a file
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of
Foreclosure Status
Not in foreclosure
In foreclosure
At risk of foreclosure
Deed Restriction Acknowledgment
What it means: A deed restriction is a legal note added to your property record that shows the County helped fund your repairs. It does not mean you’re giving up ownership or control of your home. You still own your property just like before. It simply means that for the next five years, the County may limit how much additional County repair funding you can receive.
Five-Year Deed Restriction Consent
I have read and understand the above.
Prior County Funding
Homes with an active County deed restriction can’t receive additional work (except accessibility)
Has this home ever received County-funded repair assistance?
Yes
No
Unsure
If Yes/Unsure, is there an active County deed restriction on this property?
Yes
No
Unsure
Year & program (if known)
Communication & Data Sharing
Formal Communication & Data Sharing Consent
I authorize SBTC to share my application information with Mecklenburg County for eligibility, scheduling, and compliance.
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Property Information
What year was your home built?
Property Type
Single Family Home
Manufactured Home
Condo
Multifamily Home
Mobile Home
Additional Household Members
First Name
Last Name
Relationship
Spouse
Minor
Additional Family Member
Other
Additional Household Members
First Name
Last Name
Relationship
Spouse
Minor
Additional Family Member
Other
Additional Household Members
First Name
Last Name
Relationship
Spouse
Minor
Additional Family Member
Other
Additional Household Members
First Name
Last Name
Relationship
Spouse
Minor
Additional Family Member
Other
Accessibility Needs
Is your request primarily for accessibility improvements?
Yes
No
If Yes, show: Describe the accessibility need (ramps, grab bars, widen doors, etc.)
Select Service Requests Below
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next
( X )
Wheelchair Ramp
Existing ramp repair or new ramp installation
$
Free
Porch Repair
Existing porch repair includes removal and replacement of rotten wood
$
Free
Quantity
1
2
3
4
5
6
7
8
9
10
Drywall Repair
Repairing drywall holes in walls that present a hazard. Repair only available if the source issue has been rectified.
$
Free
Quantity
1
2
3
4
5
6
7
8
9
10
Handrails/Grab Bars
Interior or exterior handrail/grab bar installation for increased safety
$
Free
Quantity
1
2
3
4
5
6
7
8
9
10
Flooring
Floor transition replacement or laminate repairs only. Whole flooring replacement not available.
$
Free
Quantity
1
2
3
4
5
6
7
8
9
10
Faucet Repair/Replacement
Leaking kitchen or bathroom faucets may be repaired or replaced depending on the extent of the issue
$
Free
Quantity
1
2
3
4
5
6
7
8
9
10
Toilet Repair/Replacement
Toilets may be repaired or replaced depending on the extent of the issue
$
Free
Quantity
1
2
3
4
5
6
7
8
9
10
Electrical Outlet Replacement
GFCI outlet installation for wet areas and standard outlet replacement available.
$
Free
Quantity
1
2
3
4
5
6
7
8
9
10
Light Fixture Replacement
Replacement is only available if current fixture poses a safety hazard.
$
Free
Quantity
1
2
3
4
5
6
7
8
9
10
Exterior Door Replacement
Inoperable doors are available for replacement
$
Free
Quantity
1
2
3
4
5
6
7
8
9
10
HVAC Request
Please complete all questions if you’re requesting HVAC assistance.
Does your system turn on?
Yes
No
Does it operate efficiently in both Heat and AC?
Yes
No
What is the approximate square footage of your home?
1000 square feet or less
1200-1500 square feet
1500-1800 square feet
Where are your vents located?
Floor
Ceiling
Wall
What is the main fuel source?
Gas
Electric
Approximate age of your system?
10 years or less
10-15 years
15 or more years
Are there any rooms that do not have any air flow?
Yes
No
Has the system been maintained within the last two years?
Yes
No
Does your bathroom(s) have exhaust fans?
Yes
No
Does your dryer need to cycle more than once for clothes to dry?
Yes
No
Is your water heater gas or electric?
Gas
Electric
How did you hear about this opportunity?
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By signing below I understand that I have read, understand, and agree to all of the terms of this application and that I am the primary owner of the subject property. I understand that the repairs will be completed by Apprentices enrolled in the She Built This City Program and are supervised by trained professionals. My signature further indicates that I declare and swear that if I receive critical home repairs, I will reside in my home for a minimum of five (5) years upon completion of such repairs.
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