DEKALB COUNTY ENTERPRISE ZONE APPLICATION Project Information Project Name: Street Address: City/State/Zip: Mailing Address: City/State/Zip: (the exact legal name under which the business is applying for designation) (location of the qualified business within the Enterprise Zone) If constructing a new facility and address is not available, provide address to the Economic Development Office as soon as it is available. The address must be provided to the Office before the project is eligible for benefits. Local Business Liaison (Local Contact Person at Qualified Business Site) Primary Business Representative (Primary Business Representative with Signature Authority as Identified in Corporate Resolution) Name Title Organization Street Address Mailing Address City/State/Zip Telephone Fax Number TDD Number Parent Company (If applicable) Street Address Mailing Address City/State/Zip 1
Complete Incomplete If Complete, Initial and Attach Financial supporting documentation for example, bank commitment letters. Three years of financials (must include income statements and balance sheets). Ten (10) year Operating Proforma (including annual debt coverage ratio) Evidence of property access, i.e., copy of warranty deed or executed lease agreement (i.e., evidence of site control.) DeKalb County Business License or application. Statements from 2 or more lending institutions verifying that tax exemptions are necessary to the economic feasibility of the proposed project. Business Type: Federal Tax ID Number: NAICS (SIC) Code (4 Digits) Business Type: Primary Product: (Manufacturing, Service, Etc.) Business Characteristics: Check the Appropriate Box(es) Applicant Type New Job Exporter Retained Jobs Non-Exporter New & Retained Jobs Importer Benefit Type Renovate Existing Facility New Facility Expand Existing Facility Machinery/ Equipment Recruitment Type (Out-of-State) Expansion Consolidation Relocation Start-Up Expansion Consolidation Retention Type (Local) Relocation within Georgia Upgrade Process/Equipment 2
Permits: (provide the status of all local, state, and federal permits) No Permits Required If pending, the Issuing Agency Status Date Expected Current Pending N/A Current Pending N/A Current Pending N/A Current Pending N/A Note: Do not attach copies of permits. Jobs for which you are applying for EZ Designation: Jobs to be created for EZ Designation: (Projected for 10-year Designation Period) Number of New Jobs Total Amount of Payroll for New Jobs $ NOTE: Leased, contract, temporary, and construction employees do not qualify as new employees. Number of Local Residents Hired: Permanent, Full-Time Jobs: Number of Low/Moderate Income Hired: Job Number of Estimated Wage Estimated Title Positions Range per Job Annual Wages Sub-Total, Full-Time Jobs: Sub-Total, Permanent, Part-Time Jobs: Sub-Total, Seasonal Jobs: Sub-Total, Temporary Jobs: GRAND TOTAL, ALL JOBS 3
USES OF FUNDING FOR PROJECT: DeKalb County Enterprise Zone Sources and Uses Development Budget, Pre-Development Costs Property Appraisal Market Study Environmental Report(s) Soil Borings Boundary and Topographical Survey Zoning/Site Plan Fees Acquisition: Land Acquisition Legal Fees (if existing structures involved) Existing Site Improvements Demolition Site Preparation and Site Utilities Off-Site Improvements Site Drainage $ $ $ Construction Buildings Landscaping, Lighting, Signage Streets, Walks, Parking Accessory Building(s) Project Amenities Construction Contingency: Actual % = Contractor Services Builder s Overhead Builder Profit General Requirements Construction/Financing and Permanent Fees Construction Loan Fee Construction Loan Interest Construction Insurance Permanent Loan Fees Title and Recording Fees As-Built Survey $ 4
Professional Services Architectural Fees Engineering Fees Attorney Fees Accounting Local Government Fees Building Permits Water Tap Fees Sewer Tap Fees Developer s Fee Developer s Overhead Consultant s Fee Short-term Reserves (held for less than life of loan) Developer s Fee Start Up and Reserves Rent-up Reserve/Working Capital (longer than life of loan) Marketing Operating Deficit Reserve Replacement Reserve Total Development Budget: SOURCES OF FUNDING FOR PROJECT: $ $ $ $ $ $ Provide all sources of funding and supporting documents, (i.e., bank commitment letter, statement of any federal, state or local government funds committed to the project.) Source (1) Source (2) Source (3) Source (4) Source (5) Total Sources of Funding: $ Additional Clarification (if necessary): 5
NOTE: You may replicate this page on computer or substitute company documents and substitute the replicated page as part of the application. Please provide concise and informative answers. The Business. In narrative form, provide an introduction, history, and description of the qualified business, its products, services, total sales, number of employees, locations (international, national, and in Georgia), description of primary materials purchased, product transportation, etc. Additional Economic Stimulus. In order to receive an Enterprise Zone designation, a qualifying business must provide additional economic stimulus in the zone. The quantity and quality of such additional stimulus shall be determined on a case-by-case basis (24-103(10) of the DeKalb County Enterprise Zone Ordinance) In narrative form please address the additional economic stimulus the proposed project brings to DeKalb County. 6
Business Projected Dates and Milestones: Construction Start Date: Construction Completion Date: Operations Start Date: Date to Begin Hiring New Employees: Project Information: Proposed business is located in what census tract? What is the acreage of the site? What is the total building square footage of the development? How is the proposed site currently zoned? Does the project require a variance or zoning change? Who are the District and Superdistrict Commissioners? What is the proposed development activity: New Construction Rehabilitation Adaptive Reuse Acquisition/Rehabilitation What is the Tax Parcel ID number? Provide a location map for the site Yes No Provide photographs of proposed site (include bldgs if applicable) Yes No Provide a Boundary Survey Yes No Provide the name of the current owner Type of Building Construction: Combustible (wood) Non-Combustible (concrete; steel) What is your anticipated estimated gross receipts for year one following EZ designation? Check off type of business: gymnasium restaurant theater office/business research/eng service station school factory hazardous convalescent hospital hospital department store retail store mall concourse auto parking structure private garage homes for elderly mall store repair garage hotel motel warehouse department store auditorium other 7