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L <br />4 ',r <br />Homelessness and Affordable Housing Funds <br />2017 Request for Proposals Application Form <br />4 <br />"Fields outlined in red are required" <br />PROJECT INFORMATION <br />Project Title: 14 -Critical Home Repair Projects <br />Project Site Name(s): To be determined <br />Project Site Address(s): To be determined <br />Which fund source is this proposal for? (select one, see Section 1 of the RFP for details) <br />G) Affordable Housing Funds <br />Homeless and Housing Assistance Funds <br />Total Project Costs (including other funding and resources): $140,000.00 <br />Total Amount Requested (from Kittitas County Homeless Housing and Assistance or Affordable <br />Housing funds): $60,000.00 <br />Time Frame for Utilization of Requested Funds: 2018-2023 <br />City, Town or Unincorporated Area to be served: Kittitas County, Washington <br />APPLICANT INFORMATION <br />Name of Applicant Organization: Kittitas County Habitat for Humanity <br />Mailing Address: P.O. Box 873 <br />City, State, zip: Ellensburg, WA 98926 <br />Phone: 509-962-5058 <br />Fax: 509-962-5066 <br />Email Address: sherri.ott@kchabitat.org <br />