Author: STUDIO

Wichita County

Neighborhood Revitalization Application

Part 1: Application for Tax Rebate.
A non-refundable $300.00 application fee must accompany this application.

Applicant’s Name:
Please list all properties with the same ownership on Appendix A.
Company (if applicable):
Applicant’s Address:
City:	State:	Zip
Daytime Telephone:

Property Information
Address of Property:
Legal Description of Property:
Does the applicant own the property?
Will the proposed project be permanently attached to the property?
Proposed Use of Property:

Residential Project
Check the appropriate boxes below, then
complete the correlating part of the application.

Commercial/Agricultural
Check the appropriate boxes below, then
complete the correlating part of the application.

OR

New
Existing
Owner-Occupied / Rental
Rental Property
Single Family
Multi-Family, Number of Units

Agricultural, New
Agricultural Existing
Commercial New
Commercial Existing
Owner Occupied
Rental Property

Agreement & Signature
I have read and do hereby agree to follow all application procedures and criteria. I further understand that this application will be void two years from the date below, if improvements or construction are not complete. Therefore, my participation in the Neighborhood Revitalization Program will be terminated. I further agree to complete the applicable portions of the questionnaire attached to this application.
Signature of Owners		Date
Please use Appendix A for ownership listing and signatures if the project has more than one owner.

Residential
Any and all financial information on this form will be considered confidential and will not be subject to public disclosure as provided in K.S.A.45-221 (b)

Estimated Date of Completion:
List of buildings proposed for demolition:
Property Construction - Please describe the project (contractor-built, owner-built, combination owner/contractor-built, manufactured housing, pre-built, detailing whether new or refurbished):
Residential Remodel - Please describe the type of remodeling to be done, i.e. kitchen, bathroom, bedroom, any additions, etc.:

Estimated Cost of Improvements

Please attach copies of blueprints or plans as well as a building permit, if project will be built in Leoti.
Materials	$
Labor	$
Total Costs	$

Commercial or Agricultural
Any and all financial information on this form will be considered confidential and will not be subject to public disclosure as provided in K.S.A.45-221 (b)

Estimated Date of Completion:
List of buildings proposed for demolition:
Property Construction - Please describe the project (contractor-built, owner-built, combination owner/contractor-built, pre-built):
Commercial or Agricultural Remodel - Please describe the type of remodeling to be done:

Estimated Cost of Improvements
P

Please attach copies of blueprints or plans as well as a building permit, if project will be built in Leoti.
Materials	$
Labor	$
Total Costs	$

Part 2: County Appraiser’s Action on Application
Subject to meeting the minimum increase in appraised value directly attributable to the improvement requirement of $50,000.00, the above application is hereby (Check Box Below).
Signature of County Appraiser		Date:

Conditionally Approved

Denied

Part 3a: Completion of Improvement

Owner’s Name:
Company (if applicable):
Applicant’s Mailing Address:
City:	State:	Zip
Daytime Telephone:
Parcel ID Number:
Date of Original Application:
Building Permit Number (if applicable):
Date Construction Started:
Date of estimated completion of construction:

Signature of Owner		Date:

Part 3b: Status of Construction Completion
Please report the status of this project if the construction is going to enter into the next calendar year before completion. Please report the percentage of the completed project on December 31 of the current calendar year to the Wichita County Appraiser.

Appendix A: Project Ownership
Any and all financial information on this form will be considered confidential and will not be subject to public disclosure as provided in K.S.A.45-221 (b). Attach additional sheets if necessary.

The following individuals have ownership interests in the project and agree to the terms of the application:
Name		Signature
Please list any other entities you belong to with Wichita County ownership interests:
Name		Signature
Please list any other entities you belong to with Wichita County ownership interests:
Name		Signature
Please list any other entities you belong to with Wichita County ownership interests:
Name		Signature
Please list any other entities you belong to with Wichita County ownership interests:
Name		Signature
Please list any other entities you belong to with Wichita County ownership interests:

Application Checklist

Neighborhood Revitalization Working Group Use Only

The project is anticipated to cause less than a $500,000 increase in valuation.
Part 1 is complete.
Appendix A is attached to document all owners of the project (if necessary).
Part __ (2 or 3) is complete.
Blueprints or plans are included
The building permit is attached.
Add application review to County Commissioner meeting agenda
Signature: ________________________________________
Wichita County Clerk
Date: ____________________________________________

Construction has not begun on the project.
Verified: ________________
The project is anticipated to cause less than a $500,000 increase in valuation.
Reviewed application.
Owner has been notified of application approval or denial.
Signature: ________________________________________
Wichita County Commissioner
Date: ____________________________________________

Construction has not begun on the project.
Verified on: ________________
The project is anticipated to cause less than a $500,000 increase in valuation.
The baseline (starting) taxable value of the property is __________ and has been confirmed with the Wichita County Appraiser’s Office.
Part 1, 3, & Appendix A is completed by owner.
Part 2 is completed by the County Appraiser.
The building permit is attached (if within City of Leoti).
Owner has been notified of application approval or denial.
Submit to NRP Folder.
Signature: __________________________________________
Wichita County Appraiser’s Office
Date: ______________________________________________

The project is anticipated to cause less than a $500,000 increase in valuation.
Part 1 is complete.
Appendix A is attached to document all owners of the project (if necessary).
The owners or owners are current on all Wichita County taxes.
Part __ (2 or 3) is complete.
Blueprints or plans are included
The building permit is attached (if within City of Horace or Tribune)
A $300 check, payable to the Wichita County Treasurer, has been submitted.
Signature: __________________________________________
Wichita County Treasurer
Date: ______________________________________________