Façade & Renovation Grant

Property Owner Consent Form

This form must be completed by the property owner when a tenant business is submitting a Façade & Renovation Grant application. A copy of the least agreement demonstrating the tenant’s right to occupy the property must able be submitted.

PROPERTY INFORMATION

Property Street Address / City / State / Zip(Required)

Parcel ID / Tax Map Number(Required)

PROPERTY OWNER INFORMATION

Property Owner Name(Required)

Owner Mailing Address / City / State / Zip(Required)

Owner Phone(Required)

Owner Email(Required)

TENANT / APPLICANT INFORMATION

Tenant Business Name(Required)

Tenant Contact Name(Required)

Tenant Phone / Email(Required)

Lease Term (Start – End Dates)(Required)

CONSENT STATEMENT

I, the property owner identified above, hereby provide my consent for the tenant named above to apply for and receive the City of Staunton Enterprise Zone Façade & Renovation Grant for improvements to the property at the address listed above.

I understand and agree to the following:

The proposed improvements described in the grant application have my knowledge and approval.
All work will comply with applicable building codes, zoning requirements, and design guidelines.
Grant reimbursement funds will be disbursed to the applicant (tenant) unless otherwise agreed in writing.
I agree to allow City staff or representatives to inspect the property as necessary to verify project completion and compliance.
Any improvements made to the property under this grant shall remain with the property unless agreed otherwise in the lease.

Printed Name(Required)

Title / Position(Required)

Business Name(Required)

Date(Required)