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Homelessness and Affordable Housing Funds <br />2021 Notice of Funds Available Application Form <br />'*Fields outlined in red are required** <br />PROJECT tNFqRMATION <br />Project Title: Cle Elum New Build <br />Project Slte Name(sl: Hopesource Cle Elum New Build <br />Project Site Address(sl: withhetO <br />Which fund source is this proposal for? (select one, see Section 1 of the NoFA for details) <br />&a <br />TotalProject costs (incruding otherfunding ond resourcesJ: $1 s]g1,Tzr.0o <br />Total Amount Requested (from Kittitos County Homeless Housing ond Assistance or Afiordable <br />Housing fundsl: $750,000.00 <br />Time Frame for Utilization of Requested Funds: DeCember 2OZ1_DeCemb ef 2023 <br />Citn Town or Unincorporated Area to be served: Cle Elum <br />APPTICAIVT I NFORMATION <br />Name of Applicant Organization: HOpeSOUfCe <br />Mailing Address: 700 E Mountain View Ave Suite S01 <br />City, State, zip: f lJgnSbUrg, WA 98926 <br />Phone: 509,925.1449 <br />Fa* gQg-g2$-1204 <br />Email Address: Skgrindle@hOpesgurge.us <br />Affordable Housing Funds <br />Homeless and Housing Assistance Funds