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Indiana Main Street

Downtown Enhancement Grant

Application Round 2017

Indiana Office of Community and Rural AffairsIndiana Main Street

One North Capitol, Suite 600Indianapolis, Indiana 46204

This is a competitive grant program designed to enhance the development and revitalization of downtown business districts in Indiana’s Main Street communities. The Indiana Main Street Downtown Enhancement Grant will provide financial resources for a variety of initiatives to aid Main Street communities in their downtown revitalization efforts.

Downtown Enhancement Grant 2017 1

Section I: Introduction

Purpose

PurposeThe Indiana Office of Community and Rural Affairs (OCRA) is announcing a competitive funding round for Indiana Main Street (IMS) programs. The Downtown Enhancement Grant (DEG) is designed to foster innovative approaches to activities that

1. Support and promote community based planning, marketing and restoration efforts;2. Improve the image and quality of life within the community;3. Increase private investment and employment;4. Strengthen the community's historic and cultural brand.

One of OCRA's priorities is to provide resources that would assist in promoting the economic development of downtowns. OCRA intends to ensure that resources are available to aid communities in their efforts to strengthen the economic vitality of rural downtown communities.

Projects

Eligible projects will promote economic development in the downtown area, strengthen the unique brand of the community, and enhance the quality of life in the community. See Eligible Uses of Funding section on page 5 for details.

If the applicant has any questions regarding project ideas, competitiveness, and eligibility of a project contact your OCRA Community Liaison prior to grant submittal. See the Community Liaison contacts at http://www.in.gov/ocra/2330.htm (http://www.in.gov/ocra/2330.htm).

Eligible Applicants

The Indiana Main Street organization must serve as the lead applicant for the grant. In situations where the Main Street organization is not a not-for-profit organization, another partner may serve as the fiscal agent. The partner fiscal agent will fill out a Partner form. In order to be eligible the community must not have received a Downtown Enhancement Grant within the past 3 years. Any IMS organization awarded dollars prior to January of 2014 is eligible to apply.

Partnerships

A competitive project will have at least one partner with another community agency: Local unit of government, community foundation, financial institution, chamber of commerce, tourism, historic preservation, local economic development organization, youth organization, educational institution,or other interested party. Such partnerships should be formed to address the critical needs of Indiana's downtown business districts. Partners must contribute either financially, as in-kind, or as a documented planning or advisory partner for the project. More than one partnership is required and 5 bonus points are given for youth engagement in the project during the design or implementation phases.For example:

- Cash match from the Chamber of Commerce or Tourism- in-kind labor/installation from the Garden Club- Historic Preservation serves on the façade project review committee

Please contact your OCRA Community Liaison with partnership questions to verify their eligibility.


http://www.in.gov/ocra/2330.htm

Section II: Requirements

Qualifications to Apply1. An IMS Community must be the lead applicant and be an active organization in the community.2. The Indiana Main Street Community must also submit reports requested by IMS within the reporting deadlines and consistently meet the criteria to maintain their current level of participation as set by the IMS office including your annual IMS assessment due January 31st.3. The organization has attended at least one required training by Indiana Main Street in the 2016 or 2017 calendar year-these include the OCRA regional conferences and the Main Street Exchanges4. Qualifying Main Street organizations may be operated with paid or volunteer staffing.5. Lead applicant must be in good standing with the State of Indiana.6. Have at least one partner with a community organization.7. Not have received DEG funding after January 1, 2014. Any communities with an open DEG award at time of application announcement, no matter funding year, are considered ineligible8. Completes a successful application for Certificate of Approval (State Form 52889) if the property or project falls within a historic district or impacts a historic structure

*An active Main Street organization is one that has an active and productive governing group that focus on implementing the Four Point Approach and work toward fulfilling their mission statement as well as their work plan. The communities can verify their participation status by contacting their Community Liaison: (http://www.in.gov/ocra/2330.htm).

Certificate of ApprovalIf your project falls within a historic district or impacts a historic structure, you must complete an application for Certificate of Approval. (State Form 52889)The application for Certificate of Approval must be completed, attached as the last portion of the application and submitted with your application. These documents are reviewed and approved by the Department of Historic Preservation and Archeology (DHPA) within 30 days. Grant requests who do not submit an application or fail to meet eligibility through DHPA will not eligible for funding.

Note: Instructions for completing this document can be found on our website

Funding

Grant requests from $5,000 to $10,000 will be considered. Selected Grantees will be allowed to use the funds for the duration of the project period according to the start and end dates noted in the grant agreement, not to exceed 18 months.

The grant will require a 1:1.5 match. For each DEG dollar requested, the match must be one and one half dollar. Of that, at least one dollar must be a cash match while the balance can be certain in-kind contributions. A higher ratio of match - up to 1:3 - will receive up to five bonus points in scoring.

Note: This does not prevent a community from including more match than the 1:1.5 match requirement.

Example of Cash MatchDEG Grant Request

Local Cash Match

Local in-kind Match

Total Project

$10,000 $10,000 $5,000 $25,000

Letters identifying the source and amount of the cash match are required. Proper documentation must be provided on the letterhead of the organization that will provide the cash match and be signed by the chief executive or chief financial officer. The letter must state the amount


http://www.in.gov/ocra/2330.htm

contributed, that the funds are available at the time of the application, and are committed for the entire grant period. This includes match from the Main Street organization/Lead applicant as well.

Selected grantees will be permitted to utilize the funds for the duration of the project period according to the start and end dates identified in the grant agreement, but cannot exceed 18 months. Grant funds may only be utilized to cover eligible costs associated with the execution of the project as outlined in the grant agreement.

Federal and other state funds may not be used as local match. OCRA’s Downtown Enhancement Grant encourages collaboration and leveraging of local resources to address the challenges faced by a community. The intent is to encourage local community investment in the project. Philanthropic foundations, especially community foundations, are strongly encouraged to participate and provide cash match.

Professional and consultant fees are an ineligible grant expense but can be paid out of local match. Fees should be limited to 10% of project cost. If you have an in-kind match, you will need to fill out a Partner Sheet and the in-kind Donor Form. The form will show what portion is in-kind and from what source. Note: More than 10% match in-kind is allowed but will not count towards the 1:1.5 match. Please include all in-kind match including labor, installation, and administrative costs.

Eligible Uses of FundingExamples of eligible costs include but are not limited to:

• Project costs as they relate to façade and roofing renovation*• Local façade grant program• Local matching grant program for roof repair• Local matching program for re-use (green space, gardens, etc.)• Combined façade - roofing grant program• Downtown building renovation revolving loan program• Creation and Restoration of murals• Streetscape/landscape design and/or implementation• Wayfaring signage• Trash and recycle receptacles• Bike racks• Pocket parks• Lighting• Other similar purposes that strengthen the economic development efforts of your downtown• Professional Fees including consultation and contractual fees are allowed up to 10% but must be paid from local match.• Trees, planting, and tree guards must be paid from local match. However, hardscaping such as planters can be paid out of DEG grant dollars

*Roofing repair, improvements or reuse must meet the following criteria:o Roofing for the building only, no awnings, patio or enclosed structureo Guttering must be part of the roofing project as a wholeo All program guidelines must be included in the application and will need to be

approved by OCRA if funded

Eligible in-kind Costs to be Used for Local MatchThese are examples of eligible in-kind costs, but are not limited to just these.Downtown Enhancement Grant 2017 4

During the 18 month project period:• Volunteer hours tracked at $10 an hour for labor and $25 an hour for professional services. These must be directly related to the execution of the DEG project.• Grant administration expenses capped at 10% of the grant amount.• Site preparation and construction services• Donated equipment related directly to the DEG project• Signage at the project site

Up to 18 months leading up to the grant application Paid studies, renderings, etc. specific to the proposed project completed within the past 18

months Land acquisition at or below market rate for the proposed project

Ineligible Uses of Funding

A project budget (including local match) may not include:

• The purchase of capital equipment;• Traditional visitor collateral - i.e. brochures, rack cards, guidebooks or other marketing

materials;• Operational expenses for Main Street groups or local businesses such as rent, utilities,

insurance, salaries;• Printing, copying, binding, etc.;• Funding to purchase a facility;• Costs to supplant existing funds (the funding opportunity must be used for expansion of

existing services or implementation of new services); or• Direct financial support to provide start up or operational capital to businesses.• Restroom facilities;• Living plants, greenery or shrubbery• Wi-fi;• Pools; • Splash pads

Reporting and Records Retention The grantee will submit a progress report with each claim for funds, which will include a narrative and financial expenditures section. The format of the report will be provided to the lead applicant upon selection for funding.

Funded projects will be expected to maintain supporting financial documentation of grant expenditures sufficient to enable an audit by the State of Indiana and for monitoring by OCRA or Grant services staff.

Projects are expected to maintain records as appropriate to the type of project being implemented. All records should be maintained for three years beyond the close of the grant period. OCRA or Grant Services staff may audit these records for the life of the project.

Financial Reimbursement Procedures


Below is the breakdown of the release of funds:

Upon receiving a fully executed grant agreement, the grantee may request 50% of the funding; An additional 25% upon submission of copies of invoices for work completed to date and

documentation that payment has been made such as cancelled checks, demonstrating that the initial funding has been spent; and

The remaining 25% awarded upon 100% completion of the project once proper financial documentation has been submitted as identified above.

The project must be initiated within three months of the award date and completed within eighteen months.

Necessary paperwork and documentation for reimbursement and reporting requirements are included as part of the application. Grantees must be willing to establish themselves as a direct deposit vendor with the State of

Indiana and maintain appropriate financial records that would permit an audit by the State of Indiana and OCRA. Grantees must also spend funds in an equal ratio of grant dollars to local match. .

Best Practices to Keep In Mind When Completing1. If you are submitting multiple documents as part of your application, please clearly label each section

(i.e. Maps, Photos, Minutes, etc.) 2. If you include a photo clearly label what the photo is and why it is included.3. If you include a reference item (an article for example) please identify why this is included.4. If you reference an attachment-clearly reference why this is included, where it can be found and identify

what the document is (example: The Herald wrote an article about the possibilities for the park, this article can be found on page 4 with the section highlighted in yellow).

5. Have someone who is not familiar with the project proof read your application answers. If they do not understand what you are asking for or what the project is, it is likely the person reading the application will not either.

6. Be specific, write as if the person reading the application is unfamiliar with your community and your project.

7. Do not edit or reformat any of the documents.8. Be concise. Do not write a novel when a paragraph will suffice and do not write a paragraph when a

sentence will suffice. 9. Include page numbers for reference.10. What dollars you request in the budget, is your project. Be sure that you are asking for funds for your

overall project.11. Make sure all of your dollars add up!12. When completing your W/9 and Direct Deposit Form be certain you are using the same name, EIN

number and address you used to register as a bidder.13. When completing your W/9 and Direct Deposit Form be certain your name is the same name that is

listed on your bank account. 14. Know and understand the difference in a commitment and a support letter15. Don’t be afraid to ask questions! Contact your Community Liaison, Project Manager or anyone with

OCRA for questions.


How to Apply

Applications are submitted to OCRA via four (4) hard copies and one digital file.Application to be received by the office will consist of:

4 Hard Copies1 with original signatures3 copies-clearly legible

1 Digital File (jump drive or disc) complete with full applicationThe application must be received by the Indiana Office of Community and Rural Affairs by

4:00p.m. Eastern Time Zone on the due date either in person or by mail. The first step is to contact your OCRA Community Liaison who will be able to offer current program details, evaluate readiness to proceed, and provide application instructions. The application you will be completing is available here. THIS NEEDS TO BE UPDATED with the word doc found S:\OCRA\DEG\2017 and titled Downtown Enhancement Grant Application FINAL.

Applications MUST be received, in office, by 4:00 p.m. Eastern Time Zone on Friday, November 3, 2017

- Do not use acronyms in the grant application. - Grant forms may not be redesigned. Most documents are fillable. - A partner sheet must be included for ALL partners in order to be considered a partner.

1. Coversheet a) The Main Street Program needs to fill out this section, titled Downtown Enhancement Grant

Coversheet.

b) Does your project fall within a historic district? Impact a historic property? If so then you MUST complete an application for a Certificate of Approval (State Form 52889). The Application for Certificate of Approval state document and instructions can be found on our website. (INCLUDE LINK)

2. Partner Coversheet/ Participation Agreement a) Complete a project partner coversheet/participation agreement for each organization that will

assume an active role in the project.

b) In the space provided identify the role of the partner in the project. Partners must contribute either financially, as in-kind, or as a documented planning or advisory partner for the project.

a. These forms will work as Letters of commitment for cash or in-kind contributions.b. Forms should clearly state the amount of the contribution for the entire 18 month period

and be signed by the chief executive or financial officer.c. These letters should be written/typed on the contributing organization’s letterhead.

c) Attach additional sheets as needed in order to thoroughly identify the role of the partnering organization.

d) This section must be complete to qualify as a project partner.

e) Electronic signatures are acceptable on these forms.

3. Project Description


http://www.in.gov/ocra/files/Indiana_Shovel_Ready_Program_Application_2015.pdf

In a maximum of 5,000 words, please clearly address the following:a) Clearly identify the project. What is the scope of work? Please quantify what will take place.

b) If you are using phases please include only what the current grant dollars will pay for. Any work, either previous or post award, should be clearly articulated in the need section.

c) Identify whether the project is new or an expansion. If the project is an expansion of a current project, be very specific about what is currently being done and what the expansion will be.

Note: The continuation of existing programs is not eligible. The proposed project must be new or an expansion of an existing program.

Immediately following the Project Description narrative include the following;

A. Pictures, drawings and/or maps explaining the project and project area.

B. A timeline for the project that indicates the organization or persons responsible.

C. Any other applicable forms. For example, if you are going to do a façade grant program, include the grant application and explanation of the project that you will hand out to those in your community.

4. NeedIn a maximum of 5,000 words, please address the following:

a) Identify the need which the project will address. Why is this project a priority?

a. What are the documented issues that demonstrate the need for this project?

b. Why is this a priority for the Main Street organization?

b) How does this project fit into the overall goals and objectives of the Main Street organization?

a. Is this part of the organization’s work plan?

c) Please include any previous phases or work that has been completed on this project, also, please indicate what work will be done to build onto this project (additional phases). If the project will be completed from beginning to end with the grant dollars, there is no need to complete this portion of the question.

Immediately following the Project Need narrative include the following: Documentation of current issues (i.e. survey results, photos of current conditions, etc.)

Excerpts of applicable planning documents outlining the proposed project.

5. Goals In a maximum of 5,000 words, please address the following:

a) Clearly identify the goals of the project.

b) Clearly identify how you are going to evaluate the success of the project through reaching those goals.

Goal Evaluation Tool

(For each component in the scope of work, what goal will be addressed?)

For example: To improve four storefronts to

(What specific measurement tool or method will be used to track success?)

For example: Tracking increased sales in the


make the area more appealing for foot traffic. businesses using semi-annual reporting.

6. SustainabilityIn a maximum of 5,000 words, please address the following:

a) Describe in detail how the project will be sustained beyond the initial funding period.

a. If the project will be maintained locally, what is the cost in dollars and man-hours? Who is going to maintain the project?

b) Include the efforts or plans that have been made for future sustainability.

a. If this a stand-alone project, please provide the estimated lifespan for the items.

b. If this is an expansion of a previous community program, why was the program not previously sustained?

Immediately following the Sustainability narrative include a letter from the entity who will maintain the work specifically outlining their agreement to do so.

7. BudgetPlease include the following in the below order:*All totals on the budget forms MUST match throughout. This total must also match the total on the coversheet. In-kind must be included on all budget forms.

f) Budget Summary Form g) Table of Matching Funds h) Quotes

a. Immediately following the budget forms, quotes may be attached.

Please be sure to note the restrictions listed on pages 4 and 5, of this application, when developing the project budget. Double check your numbers to be sure the numbers match on every single page.

Coversheet


Downtown Enhancement Grant Indiana Office of Community and Rural Affairs

Indiana Main Street

Coversheet must be submitted with proposal.

Main Street Applicant (Organization Name):_ Contact person/title: Mailing address: City: Zip Code: County:_ Office Phone: Cell Phone:__________________________________________

Fax:_____________________________ Email:

Applicant's Legal Status: _________ City ___________ Town___________ County ___________Nonprofit Corporation

Project Coordinator: Mailing address: City: Zip Code: County: Phone: Fax: Email Address: Type of Project (select one) New Expansion of an Existing Program

Amount Requested from OCRA $ Request must be no less than 5k and no more than 10kAmount of Cash Match $ Amount of In-Kind Match $__________________ Total Budget: $ (Total of all Match and Amount Requested)

MY PROJECT FALLS WITHIN A HISTORIC DISTRICT OR IMPACTS A HISTORIC PROPERTY YES NOIF THE ANSWER IS YES YOU MUST COMPLETE AN APPLICATION FOR CERTIFICATE OF APPROVAL STATE FORM 52889 (6-14)PLEASE INCLUDE ONE COPY AS A SEPARATE DOCUMENT AT THE BACK OF THE APPLICATION WHEN SUBMITTING THE APPLICATION

Community Liaison Name:_____________________________________________________________________ For the Lead Applicant Identify:

Indiana State Senator: _________________________________ Email: Indiana State Representative: Email: Information can be found by visiting: https://iga.in.gov/legislative/find-legislators/

List the Counties to be served by the Project:

UPON SIGNING THIS REQUEST I AM CERTIFYING THAT APPLICANT IS NOT IN VIOLATION OF ANY STATE OR FEDERAL LAW, OR MUNICIPAL ORDINANCES AS OF THIS DATE. NO MONEY IS DUE AND PAYABLE TO ANY MUNICIPAL, COUNTY, STATE OR U.S. GOVERNMENTAL AGENCY OR DEPARTMENT, NOR DOES THE APPLICANT HAVE LIENS OR POTENTIAL LIENS WHICH COULD JEOPARDIZE THE COMPLETION OF THIS PROJECT.

Signature of Chief Official Official’s Title Date

Partner Coversheet/Participation AgreementDowntown Enhancement Grant 2017 10

Downtown Enhancement Grant Indiana Office of Community and Rural Affairs

Indiana Main Street

Partner Coversheet must be completed for all partners and submitted with proposal.

Clearly indicate any and all organizations who will be involved in the project and their role. This section should define any contribution and the amount. If an individual is contributing to the project and is not a part of an organization they should also fill out this form.

Partner Name/Organization Name________________________________________________________________

Contact person/title: Mailing address: City: Zip Code: County:_ Phone: Fax: Email Address: Applicant's Legal Status: _________ City ___________ Town___________ County ___________Nonprofit Corporation

Project Coordinator: Mailing address: City: Zip Code: County: Phone: Fax: Email Address:

Thoroughly identify the role of the organization’s involvement in this project. Full explain partner roles. Partners must contribute either financially, with In-kind, or as a documented planning or advisory partner for the project. This section must be completed to qualify as a project partner. Additional documentation for this question should be attached.

UPON SIGNING THIS REQUEST I AM CERTIFYING THAT APPLICANT IS NOT IN VIOLATION OF ANY STATE OR FEDERAL LAW, OR MUNICIPAL ORDINANCES AS OF THIS DATE. NO MONEY IS DUE AND PAYABLE TO ANY MUNICIPAL, COUNTY, STATE OR U.S. GOVERNMENTAL AGENCY OR DEPARTMENT, NOR DOES THE APPLICANT HAVE LIENS OR POTENTIAL LIENS WHICH COULD JEOPARDIZE THE COMPLETION OF THIS PROJECT. ADDITIONALLY, THE IDENTIFIED ORGANIZATION CERTIFIES THAT IT IS AN ACTIVE PARTNER IN THE PROJECT AND WILL FULFILL THE ROLE(S) IDENTIFIED ABOVE THROUGHOUT THE GRANT PERIOD.

Signature of Chief Official Official’s Title Date


Goals and Evaluation

Clearly define the steps of the project and include any necessary related items.

Goal Evaluation Tool

(For each component in the scope of work, what goal will be addressed?)

For example: To improve four storefronts to make the area more appealing for foot traffic.

(What specific measurement tool or method will be used to track success?)

For example: Tracking increased sales in the businesses using semi-annual reporting.


Scope of Work

Clearly define the steps of the project and include any necessary related items.

Downtown Enhancement Grant 2017

Example: The town of Middleville and the Theater Updates:1. The owner of the theater deeds the theater to the Town of Middleville2. Middleville obtains contract bids for the proposed updates and renovations3. Contractors are selected4. Restoration begins and includes upgrades to the sound system, updates to the stage

addition of projection screen, and painting walls and structures.5. Begin full campaign promoting volunteer opportunities and projected completion dates6. Complete proposed work7. Feature a lineup of uses and opportunities available for using the space8. Open for use

13

DEG BUDGET SUMMARY

Project Costs DE Grant Cash Match In-Kind Total

Professional Fees: (10% maximum includes consultant/contractual fees, please specify)

Signage Fees: (Up to 10% maximum project cost but not to exceed $1,500)

Subtotal:

Project Costs: (includes specific details including cost breakdown for each item, the quantity and the price)

Subtotal:

Total Grant Funds RequestedTotal Cash MatchTotal In-KindBudget Total


Budget Narrative

Downtown Enhancement Grant 2017

Example: The total budget for this project is $40,000 summarized as follows.

Professional fees total $5,900. This covers $2,200 in project design and engineering and construction supervision by landscape architect ($2,000) and engineer ($200 in-kind contribution). It also includes $3,700 for local project management ($3,500) and professional oversight ($200 in-kind contribution). Local project management includes planning, logistics, and overseeing tree removal, site preparation, tree planting, and cleanup work.

Project costs total $32,632. Material design costs of $20,632 covers trees, soil, tree guards, and miscellaneous landscape items such as weed removal, gravel, etc. in-kind labor contributed by the City street department and County jail corrections work release program is valued at $12,000. ……………………………………………………………………………………………………

.Administrative costs total $1,450: $1,200 in funds and $250 in in-kind contributions. The grant administrator will be paid $1,000 to administer the DEG; this amount.is less than 3% of the project expenses. The Community Foundation will charge $200 in service fees on the $10,000 DEG deposit. The in-kind contributions will be $100 from Clerk-Treasurer (accounting) and $150 from City Engineer (evaluation).

Other expenses of $18 (printing and mailing grant-related material) will be in-kind contributions by the City.

15

Source of Project Funds Cash Match In-Kind Match Total

Total Matching Funds

Table of Matching Fund

This form must be completed for all projects and documentation of financial commitments from all sources is required. Please note any in-kind or cash match contributed to the

project on this form

Certificate of Approval Notes:Downtown Enhancement Grant 2017 16

1. This application must be filled out completely and with as much detail as possible

2. There will be no allowable adjustments, once DHPA has rendered a decision we cannot go back and allow for edits for this funding round

3. All projects that fall within a historic district or impact a historic building must complete this application. Failure to complete this application will render the application as unable to be funded

4. DHPA is a separate organization housed under Indiana Department of Natural Resources (DNR). You may contact DHPA with questions pertaining to the Certificate of Approval. 317-232-1646 or at [email protected].

5. All DEG (non Certificate of Approval) application related questions may be directed to your OCRA Community Liaison.


Application for Certificate of Approval:

INSTRUCTIONS FORAPPLICATION FOR A CERTIFICATE OF APPROVAL

Part of State Form 52889 (6-14)

BACKGROUND

Indiana Code § 14-21-1-18(a) and (b) require that a certificate of approval be obtained before using state funds to alter, demolish, or remove an historic site or historic structure, if it is owned by the state or if it is listed in either the Indiana Register of Historic Sites and Structures or the National Register of Historic Places. The application must be submitted to the Department of Natural Resources, Division of Historic Preservation and Archaeology (“DHPA”), and heard by the Historic Preservation Review Board (“Review Board”).

A state administrative rule regarding the certificate of approval process, 312 IAC 20-3-3, took effect on December 1, 2003. The rule requires that a completed application for a certificate of approval be filed with DHPA at least forty (40) days prior to the Review Board meeting at which the application is to be considered. The rule also requires that the application be submitted on a form to be provided by DHPA. This is the form to be used for the application.

DETERMINING WHETHER A CERTIFICATE OF APPROVAL IS REQUIRED

If the state agency or its applicant for funding is not certain whether or not the project will alter, demolish, or remove a site or structure that is historic, then the state agency or applicant may ask for DHPA’s technical advice on the historical, architectural, or archaeological significance of sites or structures, or on the project’s impact on them, before applying formally for a certificate of approval. Depending on the nature of the project and the properties it could impact, the Director of DHPA or his staff may recommend that additional information be provided for the benefit of the Review Board, such as the report of an archaeological investigation of an undisturbed parcel of land, a structural report on a structure proposed for demolition, or photographs of work areas and detailed plans and specifications of proposed rehabilitation work.

Consequently, it would be advisable for the applicant to consult informally with the DHPA staff well before the forty (40) day deadline for filing the application for a certificate of approval, so that the staff could advise the applicant whether any of those additional items will be needed prior to the Review Board meeting. Similarly, the DHPA staff informally can advise the applicant of any other, obvious information deficiencies or of questions that the Review Board likely would want to have answered before the Review Board meeting.

COMPLETING AND FILING THE APPLICATION FORM

Once it is determined that an historic site or historic structure will be altered, demolished, or removed and that a certificate of approval will have to be obtained, please complete the form below. Attempt to respond to the numbered items below on the application form. If you have an electronic copy of this form, you may enlarge the space provided between questions in order to accommodate your written response. If any of the requested information will not fit into the spaces below the appropriate numbered item, then you may provide that information on additional sheets that you may attach. Also, indicate where that information may be found (e.g., “Continued on attached sheet” or “See response on page 1 of the attachment” or “Photographs attached”). If any requested item of information is inapplicable, then please explain.

Please file one (1) copy of the application form and of any attachments to the DHPA at least forty(40) days prior to the meeting at which you wish to have the application considered by the Review Board. You will be notified by DHPA staff if an additional eleven (11) copies are needed for Review Board consideration. To be deemed filed, the application must be received at the DHPA office no later than 4:45 PM on the day that is forty (40) days prior to the date of the meeting. The Review Board typically meets on a Wednesday in the last half of January, April, July, and October. You may check with DHPA to ascertain the date of the next meeting and the date on which the forty (40) day deadline falls.


BEFORE THE REVIEW BOARD MEETING

The agenda, staff comments, and applications for certificates of approval are mailed to Review Board members about two (2) weeks prior to the next Review Board meeting. The applicant’s principal contact person will receive a copy of the staff comments after they have been prepared for the Review Board members and prior to the meeting. To save on postage and copying costs, the DHPA staff prefers to send the agenda and staff comments by e-mail, so please provide an e-mail address for the principal contact person on the project.

The principal contact person and/or another representative of the certificate of approval applicant who is knowledgeable about the details of the project should plan to attend the Review Board meeting. Typically, an applicant is given a few minutes to explain the project or to highlight key points, and the Review Board members often ask questions about the application.

MAILING OR DELIVERY ADDRESS FOR THE APPLICATION

Indiana Department of Natural Resources Division of Historic Preservation and Archaeology 402 West Washington Street, Room W274 Indianapolis, Indiana 46204-2739

FOR MORE INFORMATION

Questions about issues pertaining to structures should be directed to the Historic Structures Review Section of DHPA. Questions about archaeological matters should be directed to the Archaeology Section. Either section may be contacted at 317-232-1646 or at [email protected].


APPLICATION FOR A CERTIFICATE OF APPROVALState Form 52889 (6-14)DEPARTMENT OF NATURAL RESOURCESDIVISION OF HISTORIC PRESERVATION AND ARCHAEOLOGY

Please provide the information requested in the numbered items below, or explain why it is inapplicable. Expand response spaces as needed or attach additional sheets for complete explanation.

1) Identify the state agency that will be spending or providing the funds and the entity (local government, not-for-profit organization, etc.), if any, that is applying for or that has received the state funds.

2) Provide the name, mailing address, telephone number, and other pertinent information (e.g., facsimile number and e-mail address) of the principal contact person for this application. The principal contact person may be an official or an employee of the state agency, of the applicant for funding, or of the state agency’s or the applicant’s consultant or other agent.

3) Provide the address, if any, and the nearest city or town, township, and county of the proposed project area.

4) Provide a detailed description of all construction, demolition, landscaping, earthmoving, rehabilitation, and installation activities (i.e., scope of work).

5) Provide a detailed explanation of how, and to what extent, land, buildings, structures, or objects, in or adjacent to the project area, could be physically altered or visually modified or obscured.

6) Describe the current and past land uses within the project area. In particular, state whether or not the ground is known to have been disturbed by construction, excavation, grading, or filling, and, if so, indicate the part or parts of the project area that have been disturbed and the nature of the disturbance. Be aware that agricultural tilling generally does not have a serious enough impact on archaeological sites to constitute a disturbance of the ground for this purpose.

7) State the known or approximate dates of construction of structures (including buildings, bridges, monuments, picnic shelters, historic districts, etc.) and any other historical information known about the land and structures within the project area. It may be necessary to consult a local history text, the interim report of a local historic sites and structures inventory, the county historian, or a local historical or historic preservation organization for this information.

8) State whether or not any other structures could be sold, leased, altered, demolished, or removed as a result of the acquisition or construction of a new facility, and, if so, provide the information in 5) and 6), above, for those structures.

9) Attach a map, or a good quality photocopy of a map, identifying the location of the project, and showing the relevant portion of the city or town, county, or U.S. Geological Survey quadrangle. Be sure that streets, roads, highways, railroads, rivers, lakes, etc., are clearly identified and that the boundaries of the project area and of any property to be sold leased, altered, demolished, or removed are clearly outlined in a dark ink (highlighter and pencil marks do not photocopy well). If there are other properties within or adjacent to the project area that are or may be at least fifty (50) years of age, then they should be identified on the map and keyed to written descriptions in the letter and to any photographs included with the letter and map.

10) Attach recent photographs (exterior and, if possible, interior) of any structures that may be fifty (50) years old or older and that could be impacted in any way (such as by demolition, rehabilitation, expansion, sale, taking of right-of-way, or visual modification or obscuration) by the project.

11) Provide a site plan for projects that will involve new construction, additions to existing buildings, changes in right-of-way or earthmoving activities, showing the footprint of existing and/or proposed buildings or structures with the location of all construction, changes in right-of-way or earthmoving activities on a particular lot or lots depicted as precisely as possible.

12) For projects involving the addition to, or the rehabilitation or restoration of, an historic structure, provide copies of architectural or engineering plans or specifications. Provide only those sheets that help to depict character defining features of the historic structure and how they will be altered. Reduce any plan or elevation sheets to no larger than 11” x 17”. If pertinent notes on the sheets are too small to read in reduced form, then they should be reproduced elsewhere in the application in larger print. Similarly, if the applicant believes it would be useful to provide copies of specifications for the treatment of historically or architecturally significant features, then please reproduce only the most relevant pages from the specifications.


13) If an historic site or historic structure will be altered, demolished, or removed as part of the project, then identify any alternatives that were, or reasonably could be, considered that would not have as great an impact on the historic site or structure. Discuss the advantages and disadvantages of those alternatives and their feasibility. If there are no feasible alternatives, please explain.


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