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Request for Release of Funds U.S. Department of Housing OMB No. 2506-0087 and Urban Development (exp. 12/31/2007) and Certification Office of Community Planning and Development This form is to be used by Responsible Entities and Recipients (as defined in 24 CFR 58 . 2) when requesting the release of funds, and requesting the authority to use such funds , for HUD programs identified by statutes that provide for the assumption of the environmental review responsibility by units of general local government and States . Public reporting burden for this collection of information is estimated to average 36 minutes per response , including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information . This agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless that collection displays a valid OMB control number. Part 1 . Program Description and Request for Release of Funds (to be completed by Responsible Entity) 1 . Program Title(s) 2 . HUD/State Identification Number i 3. Recipient Identification Number Community Development Block Grant NR Category I (optional) 08DB - T3 - 10 - 40 - 01 -N25 08DB - T3 - 10 - 40 - 01 - N25 4. OMB Catalog Numbers) 5. Name and address of responsible entity Indian River County Administration -A 1801 27th Street 6. For information about this request, contact (name & phone number) Vero Beach , Florida 32 960 J . Corbett Alday , Guardian CRM Inc 813 - 943 - 2627 17 . Name and address of recipient (if different than responsible entity) 8. HUD or State Agency and office unit to receive request Bill Schutt , County Senior Economic Florida Department of Community Affairs Development Planner The recipient(s) of assistance under the program(s) listed above requests the release of funds and removal of environmental grant conditions governing the use of the assistance for the following 9. Program Activity(ies)/Project Name(s) 10 . Location (Street address, city, county, State) Gifford Fire Station Neighborhood Project 3620 49th Street Vero Beach Florida 32960 ( (Unincorporated County) 11 , Program Activity/Project Description Indian River County proposes to complete a CDBG national objective with this project by providing Fire Protection/EMS facilities in a predominantly LMI neighborhood within the unincorporated area of Gifford in Indian River County . The service area is a low income , older residential area without a Fire / EMS Station . The new Fire/ EMS Station will provide for a much more rapid response time to local emergencies and fires in this LMI community . A new fire station has been designed for this project . The $ 750 , 000 in CDBG funds will pay a portion of the cost for the new Fire /EMS Station . The full cost is expected to be about $ 2 , 200 , 000 . The Project will be on vacant , undeveloped land in a residential neighborhood . The project is not within the floodplain . Local revenues of $ 250 , 000 revenues have been pledged as a match for the CDBG . The balance of funds needed will came from local revenues . Previous editions are obsolete form HUD-7015.15 (1 /99)