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MONROE COUNTY PLANNING DEPARTMENT

AFFORDABLE HOUSING APPLICATION

FOR OWNER-OCCUPANT(S)

Application Date:  __________        Permit Application No. _________      

Name(s): ____________________________________________________

Address:  ___________________________________________________ 

Phone:  (H)______________________(W)_________________________ 

Lot(s):  ________  Block:  ______  Subdivision:  ___________________

Key:  ___________     PB:  _____ Real Estate Number(s):  ___________

(If legal description is metes and bounds, attach a separate sheet)

Name of Prospective Buyers: ___________________________

Is the Project Federally Funded?  ________________  (If yes submit copies)

Submit the following information for all prospective Buyers or Owner-Occupants:

1)       Copy of the current IRS Form 1040 showing adjusted gross income for each household member.  Copies must be requested directly from IRS (minimum 6 – 12 weeks). IRS forms must be sent direct from IRS to the Monroe County Planning Department unless prepared by a Certified Public Account (CPA) and signed by all parties. If an applicant is self employed then all schedules must accompany the IRS 1040.

2)        Copy of the signed lease.  The lease agreement needs to indicate the number of occupants, the monthly rent, and the lease date.  A lease is only required when the dwelling unit is not proposed to be occupied by a home-owner.

3)       Copy of Property Record Card.

4)       Completed Affordable Housing Affidavit and Deed Restriction. (Note:  The Developer must submit these as part of application; however, do not record any documents in the Public Records at this time.)

5)       Copy of proposed floor plan showing the habitable square footage of the dwelling unit.  The floor plan is to be drawn to scale and each room labeled (ie:  bedroom, bathroom, kitchen, et ceteria).

6)       Copy of Certificate of Occupancy if already issued.

ADDITIONAL REQUIREMENTS FOR EMPLOYEE HOUSING /COMMERCIAL APARTMENTS:

7)       When the dwelling unit is for employee housing or a commercial apartment the following is also required:  1) W-2 forms is/are required to be attached to the IRS form

8)       Letter of employment (or unemployment) for each household member. If self-employed then a notarized affidavit is required.  The affidavit must specify the business name and address.  Additionally a copy of the current Monroe County Occupational License must be submitted for the business.

I certify that I am familiar with the information contained in this application, and that to the best of my knowledge such information is true, complete and accurate.

__________________________                                ___________________

(Signature of Applicant)                                              (Date)

__________________________                                ___________________

(Signature of Applicant)                                              (Date)

Sworn before me this _______ day of ____________, 2____ A.D. Notary Public Commission Expires