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NOTIFICATION TO CLEARINGHOUSE OF INTENT TO APPLY FOR ASSISTANCE <br /> (SEE IN~I'RUC~ION~g oN RE~R,SE) <br /> <br /> I. ' nformation <br /> (Fo~ State Use) 2. Date Form Completed: 3, Anticipated Submittal Dat~ <br /> 1, i SGH ~ - 1978 May 5~ 1978 __ <br /> 4. ' Applicant Age,my: Cabar~us County $. Project Director: I(704) Pb0nc. <br /> Housing ~ Community Development Dept. Frank Roberts .,,:. , ........... .~.r~8-1507 <br /> 6. Address: City: <br /> 65 Union 'St. Concord <br /> ect Information <br /> 7. P~OjdCt Title: Sidestown-BhanRletown 8. PPo]ect Location: Sidestown-Bhankletown <br /> <br /> Community Development Community, Cabarrus County <br /> 9. Project Description: <br /> <br /> Community Development Block Grant Request <br /> -for sewer facilities for the Sidestown - <br /> Shankletown Community of Cabarrus County, <br /> North Carolina. <br /> <br /> (see attached narrative) <br /> <br /> h). Project Also Submitted for Review To: <br /> <br /> I II I' III. Source of Fundin5 Information <br /> <br />G rant: Loau: sh: In-kind: ash: In-kind: <br />5498.000. $ , $ $ I _- .$ ~98.OQ( <br /> ~z. Federal Funding Ageucy Applied To: [13. Budget Period <br /> B.U.D. [ From: Oct. 1, 1978 To: Sept. 31,1979 <br /> lJ..' Source of OtheP Federal Fm~ds (Federal Agency} I 15. ~ Source of Other Non-Federal Funds <br /> I0. Federal Prc. gv~m Title: . [ 17. Federal Catalog ~: <br />Communit Develo ment Block G_rant - Discretionary [ 14,219 <br /> - _ _ ~V.' Environmental Impact Information~ <br />lq. Envi'ro~nental Statement or Assessment GHECK ONE <br /> <br /> ~--~ Completed {Attach'EIS or EA Forms) <br /> ~ IF Progress (will be submitted on ) <br /> ~ Not Required DATE <br /> <br />19. Signature of Chief Executive Official of Applicant Agency <br /> <br /> SCH #I <br /> NA,~ff~ TITLE <br /> <br /> <br />