US Dept of Housing and Urban Development 12/4/2020

Request for Release of Funds U.S. Department of Housing OMB No.2506-0087 and Urban Development (exp.08/31/2023) 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.Pro ram Titles 2.HUD/State Identification Number 3. Recipient Identification Number Community Development Block Grant B20MC530004 (optional) 4.OMB Catalo Numbers 5.Name and address of responsible entity [14-218 6.For information about this request,contact name& hone number City of Everett 2930 Wetmore Avenue,Suite 8-A Rebecca McCrary, 425-257-7133 Everett,WA 98201 8.HUD or State Agency and office unit to receive request 7.Name and address of recipient(if different than responsible entity) a Community Planning and Development 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) Homage Minor Home Repair Program Scattered sites within Everett, WA 11. Program Activity/Project Description The Minor Home Repair provides minor rehabilitation of privately owned, single unit homes. Services do not include new construction of housing units, conversion of land use, new ground disturbance, or major rehabilitation. Approximately 650 homes will be served by this program from 2020 - 2024 with Community Development Block Grant funds. Previous editions are obsolete form HUD-7015.15(1/99)