ࡱ> ܥhc e  hbX< `ASEWER HOOKUP APPENDIX Applicant #: __________________ Property address: ___________________________ Type of property: Single Family Multi Family Mobile Home CDBG assistance $____________ Other $____________ Work completed: _____________________________________________________________ ___________________________________________________________________________ 1. Is documentation present for the following? a. Property ownership Yes No b. Family Size Yes No c. Verification of income eligibility Yes No d. Work Specifications Yes No e. Cost estimates Yes No f. Construction contract with bid and specifications Yes No g. Project bid summary Yes No h. Basis for contractor selection Yes No i. Dates and amounts of disbursements Yes No j. Unit recorded on benefit data table Yes No N/A k. Unit recorded in project occupancy list Yes No N/A On Site Inspection 1. Was the contract work completed according to terms? Yes No 2. Was the work completed professionally? Yes No 3. Is the applicant/owner/tenant satisfied with the work? Yes No 4. What were the dates for the following? a. Initial application __________ b. Final payment approval __________ c. Final payment made ___________ Homeowner/Tenant comments: ______ ____________________________________________________________________________ PDS comments: ______________________________________________________________ ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Areas Needing Improvement: ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ Areas of Non-Compliance: ________________________________________________________________ ________________________________________________________________ Required Action: __________________________________________________ __________________________________________________________________ ________________________________________________________________ ________________________________________________________________ Required Action: ___________________________________________________ __________________________________________________________________ /=hxhxxhxhxxhxhxx.........~ DHNRVtx~!%(OSTY]o!'+/379K#')STPU]]]^P]P]^ PU]c[T * + l m L M T f & ' j k q   u]PcPPUPcP]^P])n=>W)d89LM()ST U V , * + l m L M   $  4hx.& ' ( ) hhh  $  4hx. & ' ( ) / & ' h k $  4hx. K@Normala &@& Heading 1]c(@"( Heading 2xxU]c&@2& Heading 3xxUc"A@"Default Paragraph Font @ Header ! @ Footer !">@"Title]c0 O" Body SinglecTo2TBullet 1: 4hxcToBTBullet 2: 4hvc*OR*First Line IndentcXobX Number List: 4h.c^or^Outline Numbering: 4h.c&O& Table Text c O Default Textc"O"Default Text:1c"O"Default Text:2c$O$ InitialStyle ]`bc T   @hTimes New Roman Symbol "Arial"Arial BlackWingdingsMonotype Sorts"%YfRdPd  <STATE OF MAINEDECDValued Gateway Client  Root Entry F`AWordDocumentCompObjjSummaryInformation(  FMicrosoft Word Document MSWordDocWord.Document.69q Oh+'0 ( P \ h tSTATE OF MAINE@_DDECDwnCFNormalValued Gateway Client 9FMicrosoft Word for Windows 95DocumentSummaryInformation8   FMicrosoft Word Document MSWordDocWord.Document.89qState of fb88 STATE OF MAINE@2~@(/Y@F@  ՜.+,0@H`h px State of fb88 STATE OF MAINE