Forms • Application For Certificate of Approval

Application For Certificate of Approval

Leave This Blank:

Business/Building Name*

Street Address*

Mailing Address*

Owner Name*

Are you applying for funding on your project or sign?

Yes

Have you received funding before?

Yes

Please provide a detailed description of your proposed project.*

Proposed start date*

Proposed project completion date

Estimated cost of improvements*

Contractor (if other than the owner or renter)

Contact information

**FOR OFFICE USE ONLY**

____________________
Historic Preservation Board Director

____________________
Preservation Board Chairperson

____________________
Date

* indicates required fields.