Letter of Intent Form

County Courthouse and Historic Preservation Restoration Grants LETTER OF INTENT
Grant Program You Are Applying For:	County Courthouse Restoration Historic Preservation Restoration
Property Information
Historic Name (if known):
Address of Property:	(required)
City:	(required)
County:	(required)
Is the property listed on the:	National Register of Historic Places Arkansas Register of Historic Places
If Yes, date listed?
Has a Conservation Easement been conveyed on the property?
If not, have you read the section of the Grant Manual entitled "Conservation Easement?" Do you understand the stipulation to convey a conservation easement? Or will you require additional information?

Project Description
Describe the proposed project to be funded by AHPP. Why is this project necessary?
Explain the current use of the property. If different, explain the future use of the property.
Architect/Consultant Information
Name:
Firm:
Mailing Address:
City:
State:
ZIP:
Daytime Telephone:
Fax:
Email:
Pre-Applicant (Property Owner)
Organization:	(required)
Contact Person:	(required)
Mailing Address:	(required)
City:	(required)
State:	(required)
ZIP:	(required)
Daytime Telephone:	(required)
Fax:
Email:
Property Photos At least one photo (with caption) is required. Maximum file size is 10MB per image. Must be in JPEG format, and at least 640 x 480 pixels.
Image #1:	(required)
Image #1 Caption:	(required)
Image #2:
Image #2 Caption:
Image #3:
Image #3 Caption:
Image #4:
Image #4 Caption:
Image #5:
Image #5 Caption:
Image #6:
Image #6 Caption: