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Homelessness and Affordable Housing Funds <br />2021 Notice of Funds Avallable Application Form <br />"Fields outlined in red are required" <br />PROJEqI INSRMATION <br />ProjectTitle: Gle Elum New Buitd <br />Project Slte Name(sf ; HopeSource Cle Elum New Build <br />Project Site Address{s}; withheld <br />Which fund source is this proposatfor? (select one, 5ee section 1 of the NOFA lor details) <br />@q <br />Total Prorect cosrs (including other funding ond resources/: $1 5,731 ,Tz7 ,0a <br />Total Amount Requested (from Kittitos County Homeless Houslng and Assistoflce or Affordable <br />Houslns funds|: $750,000,00 <br />Time Frame for Utilization of Requested Funds: lggembef 2AZ1-DeCembef 2023 <br />City, Town or Unincorporated Area to be served: Cle Elum <br />aPPUCAnTT IT|ORMATION <br />Name of Applicant Organization: HOpeSOUfCe <br />Mailing Address: 700 E Mountain View Ave Suite S01 <br />City, $tate, Zip: fllgngbUfg, WA 98926 <br />Phone: 509.925.144g <br />Fax: $Q$-$25-1204 <br />Email Address: skgrindle@hopesourge. Us <br />Affordable Housing Funds <br />Homeless and Housing Assistance Funds