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®RANT NAME; Section 302(a) Planning Grant GRANT # y , AMOUNT OF GRANT: S 75,000 DEPARTMENT RECEIVING GRANT: Community Development Department CONTACT PERSON: Robert M. Keating, AICP PHONE NUMBER: (1+07) 567-8000, Ext 246 1. ~ How long. is the grant for? 1 Year Starting Date: 10/1/91+ 2 Does the grant require you to fund this function after the grant is over? Yes xx No 3. Does the grant require a match? xx Yes No If yes, does the grant allow the match to be in In Kind Sevices? vx Yes �No 4. Percentage of match to grant 25 % S. Grant match amount required S 25,000.00 6. Where are the matchi gg funds coming from (i.c In kind Services; Reserve for Contingency)? In-kind sertices/already committed funds 7. Does the grant cover capital costs or start-up costs? Yes %X No If no, how much do you think will be needed in capital costs or start up costs? (Attach a detail listing of costs) $ 8. Are you adding any additional positions utilizing the grant funds? Yes 1X No If yes, please list. (If additional space is needed, please attach a schedule.) Position Position Position Position Acct. Description Position 011.12 Regular Salaries 011.13 Other Salaries & Wages (PT) First Year 012.11 1 Social Security $ 012.12 1 Retirement -Contributions $ 1,711 000 012.13 Insurance -Life & Health $ 012.14 Worker's Compensation $ 012.17 S/Sec. Medicare Matching Third Year TOTAL $ 9. What is the total cost of each position including benefits, capital, start-up, auto expense, travel and operating? Salary and Benefits Operating Costs Capital Total Costs 10. What is the estimated cost of the grant to the county over five years? $ Signature of Preparer: 1�24Y Z/A'� Date: e� bpd Grant Amount Other Match Costs Not Covered Match Total First Year $ a 0,9 $ $ $ 1,711 000 Second Year $ $ $ $ Third Year $ $ $ $ •$ Fourth Year $ $ S Fifth Year $ $ Is $ Signature of Preparer: 1�24Y Z/A'� Date: e� bpd