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Oshkosh
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Applicant's Name
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Work Phone
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Co-Applicant's Name
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Properly is (check one)
1f, 0\\•11<1r occupied ,inp,lc familv home [l owner occupied duple
Additional Property Information
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Liabilities and Pledged Assets
If
Debt or Loan Creditor Monthly Payment Current Balance Payment Status
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□ 0 □ □
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If N/A
w ned by household members either individually or jointly with other
Asset Type of Ownership
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Current Estimated Value
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If yes,identifyagency,when the work was done and generally describethe work that was completed:
CITY OF OSHKOSH HISTORIC PRESERVATION PROGRAM APPLICATION
Please read the following terms and conditions carefully:
Program be selected based
added;
Only those applicants who have received a signed approval letter will be qualified for program funds.
ts dated prior to the date of an approval letter sent to you by The City will not b program
may from
may project is completed.
Please initial the following:
Op,ogram funds will be used fo my
s..,VWe use my in for as (W cy:
I/We the of may or reve nt the project from being completed by the established
deadlin
program
s application and all information furnished in support of this app for
of the best my/
our
It is d,it is my/our intent to rehabilitate the aforementioned property
ac of the I/we are
I/We an of
/We a and bind me
I/\We by the City for the purpose of verifying the information provided here a
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Submit Application
Applicant Signature:
Before submitting this application,please revie make
are filled
If of
completed applications and
attachments (o:
City of Oshkosh
At: Steven Wiley
Department of Community Development
215 Church venue, P.O. Box 1130
Oshkosh, WI 54903-1130