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Jefferson County, Washington
Public Infrastructure Fund
Project Application
Return all Application Materials
in Microsoft WORD/EXCEL to:
carolyn@co.jefferson.wa.us
Date:
Project Title:
Amount requested from PIF: Percent as Grant:
Percent as Loan:
Applicant: Contact:
Address:
City, State, Zip:
Phone: Fax:
E-mail:
Responsible Official:
Signature:
Briefly describe your project. When did you start work on it? Who is involved? What is the scope of the project?
How does the project satisfy, in whole or in part, the jurisdiction’s economic development strategy?
Is this project a documented county-wide priority? If so, where does it rank?
Summarize efforts taken to date regarding the project in terms of specific steps/studies and dates of action, where appropriate.
Is the project part of a plan (capital facilities, growth management, business development, etc.)?
What engineering reports and feasibility studies have been prepared, and when?
Summarize efforts you’ve taken to date regarding the project in terms of:
Securing funding for this project from local, state or federal programs or foundations.
Specify sources, including local match and dollar amounts. If there are conditions attached to any of these secured funding sources, please specify.
d. Are there other efforts you have made that are unique to this project?
5. What are the anticipated outcomes of this project in terms of the criteria identified below? Quantify information where possible.
How will this project improve local infrastructure capacity?
How many businesses do you plan on serving with this project?
How many full-time, permanent jobs will this project create or retain?
Retain:
Create in 1-3 years:
Create in 3-5 years:
What is the size of the population that will benefit by these infrastructure improvements?
How many months will the work on this project take to complete?
7. Are there other factors significant to this project that we should be aware of, such as health and safety, emergency declaration, “bird in hand” efforts, volunteer efforts, etc.?