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- • 1 1f <br /> • c I • <br /> • HUD Application Number � <br /> -- <br /> ExistingGrant Number <br /> Nr S 1 - 1 TaA 5_ f� <br /> �l 4 <br /> 'Lz a Applicant Identification • c <br /> �`� i t �l i t � I Z � s,� �lq i u 2�3 I S ��✓ I ps�. <br /> :7. Applicants Legal Name :8, OrganizabDriall Unit <br /> Indian RiverCounty Commission ' : i • . • • Count <br /> • • <br /> 9. Address (give city, county, State, and zip code) <br /> 10. NameAltletelephone• a ' .rnumber, - • J • 1person I• • 1 <br /> • • 3 • I 1 25th Street IoDritacted on Mattem <br /> Involving this (including area codes) <br /> • Beach A- Name: Louise Hubbard <br /> C. GouW, Indian River B. <br /> Me: . • <br /> D. <br /> Phone: <br /> _ 567111111117790• ' <br /> E. ICode: 32960 <br /> • <br /> E, Eqnall- • • • <br /> Employer Identification Number <br /> a <br /> Type of • 'r (enterappropriateletter <br /> Tribe591111111160000674 A. State 1. University or College <br /> 1 : 13. County <br /> J, Indian <br /> 113. FO of • I r I • <br /> ITINew Continuation . Renewal . <br /> RevisioniTownship <br /> L. Individual <br /> I. Interstate M. Profit Organization <br /> If Revision, enter appropriate letters in box(es) oil F. Intermunicipal N. Non-proft <br /> A, Increase Amount B, Decrease Amount C. Increase Duration G. Special District 0. Public Housing Authority <br /> ,'D. Decrease Duration E. Other (Spedly) H. Independentr • n District P. Other In • <br /> 114, <br /> Nameof Federalec <br /> UsSm Departinnent of Housing and Urban Development <br /> 15, Catalog • Federal i • I Assistance i a C 16. ! G F • 1 <br /> c� -� ��• j r - • Applicant's • r <br /> li� Ii� IndianCounty <br /> I = Plus Care <br /> Assistance • <br /> lus Care for <br /> __ComponeWTITenantRental1 <br /> ssistanci � 13 Chronically Homeless Adults <br /> 17. Aran affected by Program (boroughs, cities, counties, States, <br /> Indian I <br /> Indian River • <br /> Programuntv <br /> 18a. Proposed Program start date 18b. Proposed <br /> • • = I - s • a - i ti • • • r <br /> sional Districts of <br /> 7 / 04 7 / 09 <br /> 15 f � 1 _ • • • <br /> • 1i7*1MVIt ft • it 1 LTi - <br /> 121 , is <br /> IPlication _ <br /> A Yes This <br /> • J C • • ✓ 1 • CII r- 1 • was madeavailable to the State ExecutiveOrder Process _ <br /> B. <br /> NoProgram • covered I E.O. <br /> • <br /> Program has not been selected by State for review. <br /> W No <br /> LJ Yes if "Yes, explain below or attach an explanation. <br /> • 1 <br />