SECTION 1: APPLICANT INFORMATION

SECTION 2: ENVIRONMENTAL SERVICE REQUEST

Scope of Work (Attach full narrative if needed):

Describe proposed construction, rehab, installation, or demolition work:

SECTION 3: ENVIRONMENTAL INDICATORS (Check All That Apply)

SECTION 4: COMMUNITY IMPACT & PROJECT MONITORING

SECTION 5: APPLICANT CERTIFICATION

By signing below, the applicant certifies:

• The information provided is complete and accurate
• VIHFA will be notified of changes to the project.
• No procurement or construction activities will begin until a Notice to Proceed is issued.
• No procurement or construction activities will begin until an AUGF is received from HUD and a Notice to Proceed is issued. If these activities occur prior to receipt of an AUGF and issuance of a Notice to Proceed, project funding may be jeopardized.

SECTION 6: FEE ACKNOWLEDGEMENT AND PAYMENT RESPONSIBILITY 

VIHFA, as the HUD-designated Responsible Entity, charges fees based on the level of environmental support requested. By signing this application, you acknowledge and agree to the following:

• A non-refundable administrative fee may be due upon submission of this application.
• A detailed fee estimate will be provided upon review of the Scope of Work and selected services.
• Fees are due before issuance of the Notice to Proceed (NTP).
• Additional costs may be incurred if VIHFA must secure third-party testing, agency consultations, or extended monitoring.
• Applicants are responsible for all direct and indirect environmental review cost associated with their request.

Billing Contact Information: