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 Owner Business Owner Main Street Executive Director
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
Date

Budget: *

Estimated Budget Amount

Do you plan to use any local or state grant programs or funding incentives? If yes, please list.
Upload current photograph(s) of the property that best supports your project type (high resolution only) *

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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: *

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)

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

Business Information:

Response

Business Name(s)

Business Type(s)

Name of Business Owner

Email Address

Upload business logo (if applicable)

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Should be Empty:

Project Information