6.0. EDSR 09-08-1997 ITEM 16
ECONOMIC DEVELOPMENT MICRO LOAN FUND
ELK RIVER, MINNESOTA
APPLICATION
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APPLICc �1V`1' C�l�s a;.() cfTz"Y3/ Pp
Su, r 3,�o F .Jc.
ADDRESS 7// /YI.o.,✓ Srerz */
CITY %W �•, ,c STATE/?7,) ZIP CODE _53-320
CONTACT PERSON(S) C204,a,c 4FAAr (/. ,i,e_aEx
BUSINESS PHONE G�t • 5//- €17//3 HOME PHONE 4/?.. 3.13- G 9 O..f
AMOUNT REQUESTED 41_1-0. pop bo
TERMS REQUESTED /.r E)02
ye 403•3-8 C:3
SOCIAL SECURITY NUMBERm le49-6.2-31733 FED ID # 4,0-4117,5"9,3
STATE ID # ,20,77Gg,r/
1. Type of Project:
Construction/New Building Expansion/Existing
Building
• X Equipment/Machinery Purchase )( Remodel/Commercial
Retail/Industrial
Industrial Inventory X Working Capital
Other
2 . Describe Project:
?F, E-/ 5. funk. k;14- : TA) P.e.: Ati n atrit// S74�e,CA0vrr•
14/1 /111
3. Purpose of Loan: ///� `
r/a,ctrra3e o, .�/ehi Ei e>.2ew 1�, I u�w:YUR c Ie-#sC��ds
7.4.iCCtl.4.Sc el) ACle.47/4in,,O/ c.o/ c 1� da•c Lt{ !v J�rS 7�we ra.r✓
v) �uICLE✓ASE Ofr, CerkTR;N /k-743'!�^�/cl' /.ac Vg-wc vS
s) L(s‘ wdn. 47 Ciao•4/ .1L. b3;NO-sX .oALS/N
4 . Cost of Project:
A) Land $ 31.000
B) Buildings (attach plans & costs) $ /0000
• C) Equipment/Machinery/Fixtures (attach list
and estimated costs) $ l(8050
D) Remodeling $ C.coo
E) Industrial Inventory/Working Capital $ /(7-880
F) Other (attach description) as:•, (a,;:s $ /4(.Sao
TOTAL COSTS $ -73,2. 000
5. Proposed Financing:
SOURCE NAME TERMS AMOUNT
A) Bank Loan $
B) Bank Loan Vatox
C) Other Private Funds' $
D) Applicant Contribution $34 000 _ . ,
E) Other $
F) Fed Grant/Loan411 $
G) State Grant/Loan $
H) This Loam EDA - $30.non -
TOTAL FINANCING $,23,2oy)
_2_
' 6 . collateral to be assigned (Describe and show lien position) :
A) To Bank: ..VJ Y -✓.k kseN S-
i f: nit
/NVepvsogy / n ,/ /» /
B) To 41 .- (-a .,.Osu/, en eoCN•K S/' �'• rred,C.r? j Talc O7Ni.v �AiER.r y S`�°�It
141 C) To Private Funding Source:
D) To Other Source:
E) To Federal Govt:
F) To State:
G) To This Loan: 5„,,-(A )
7 . Value of Collateral:
COST BOOK VALUE EXISTING
LIENS
A) Land $ 17 GNU $ .37.cez, $
B) Buildings $ i.173X $ /57.302v $
C) Mach. & Equip. $ .2/.636 $ ,?4634 $
D) Other, r,{,/jc $ /4,1)f $ /G 60'7 $
E) Other $ $ $
8 . Employment*:
0 Present: # of Employees V Total Payroll 3 -co/,h, o
After Project: # of Employees 6 Total Payroll %Ko
*If Loan is for Job Retention Only, Explain in Business Plan.
9 . Attorney, Accountant (Names, addresses, phone) :
s4Ku6-/ // -o1, - • (A„y) . --: A4,:i 2
/330 c5. 7.epNTA6E /Cc./ ?CO- OAh/ ...a/ 7 &CS
/,/A.57/..,7 3 l 4'7.o Ss'O 33 (?ac 7./.:.,, /72 .5--S3/4
10. Bank and Other Credit References (Names, addresses, phone) :
/✓4 ce.),4-ss 2•...,.4 A/4. 7A✓A .E"/J 2.,.en_
C9/5,,,t. .5,7)E,_ -las .79 76 C/0-14,--4,../4v,4/ 2,sav,//- ( /11,2 S3-'//3
Vi/ci' l OcA L..'D lA
Cvv T.o^/ CA,7
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11. Attach and include the following:
410 __4L_A) Written Business Plan:
1. Description of Business
2. Ownership
3 . Management
4 . Date established
5. Products/Services
6. Future Plans
B) Financial Statements for past two years
_C) Financial Projections for two years
D) Resume of Owner/Management
E) Personal Financial Statements of proprietor, partners,
guarantors
F) Letter of commitment from applicant pledging to complete
during the proposed project duration S jy �zoJ
G) Letter of commitment from the other sources ofiffinanci g,
stating terms and conditions of their p
artion n
project
H) Other
•
_I) Other
__)J) Fee (1% of amount of loan request) 4 v
•
1
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s
I/We certify that all information provided in this application is
true and correct to the best of my/our knowledge. I/We authorize the
City of Elk River and the Finance Committee to check credit
references and verify financial and other information. I/We agree to
provide any additional information as may be requested by the. City
and the Finance Committee.
DATE 2/6 ;7/97 /
Applicant Name rimer,b .v,.t. . -r = —1 - /40e; z �/
for,
By / 4, _dt L 'c `-- •. ,f, 0 /. +ws rex
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4
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