Part I - Application For Valdez Housing Incentive Grant

Part II - Extension Request For Valdez Housing Incentive Grant

This form is intended for those who have already completed Part 1 of the process and require an extension on the completion of their project.
Prior to completing this form a permit extension request needs to be submitted and approved. That form can be found here: https://valdezak.jotform.com/230957344111047
Name*

First NameLast Name
Phone Number*

Area CodePhone Number
E-mail*
example@example.com
Physical & Mailing Address *

Physical Address

Mailing Address

CityState

Zip Code
Permit Number
As of January 1 following the commencement of construction, approximately what percentage of the improvements are complete?
Upload a copy of your permit extension.

Cancelof
Updated Estimated Completion Date

MonthDayYear
If construction is not completed within 3 years of the issuance of the above associated building permit, this application will be voided and grant will not be issued.
Terms & Conditions
Signature*

Clear
Should be Empty:

Part II - Extension Request For Valdez Housing Incentive Grant