PARTICIPATION REQUEST FOR LEAD HAZARD REDUCTION GRANT To: Urban Redevelopment Authority Pittsburgh From: Name: ______________________________________ The undersigned hereby request participation under the Lead Hazard Reduction Grant Program with respect to the property located at _______________________________________, in the ________ Ward of the City of . The above property was constructed before 1978, and there may be a possibility of lead based paint. The undersigned acknowledge that the Urban Redevelopment Authority of Pittsburgh will provide a grant covering 25% of the total cost up to $10,000 of lead hazard reduction work to be performed at the above address according to a Risk Assessment, which will be performed once my application is approved and referred to the Urban Redevelopment Authority. I also acknowledge that there is a $300.00 Lead Fee, which will be included as part of the grant for the lead hazard reduction work. I also understand that if there is any lead hazard reduction work to be done, it must be performed by a contractor who is certified to do lead reduction work. I/We hereby authorize the Urban Redevelopment Authority of Pittsburgh, its employees or its designated agent, to enter upon the above premises for the purpose of inspecting the property and preparing the specifications for lead hazard reduction and any required associated rehabilitation of the structure. _______________________________ ________________________ Borrower Date _______________________________ ________________________ Co-Borrower Date NOTIFICATION Watch Out for Lead-Based Paint Poisoning
PARTICIPATION REQUEST FOR LEAD HAZARD REDUCTION GRANT To: Urban Redevelopment Authority Pittsburgh From: Name: ______________________________________ The undersigned hereby request participation under the Lead Hazard Reduction Grant Program with respect to the property located at _______________________________________, in the ________ Ward of the City of . The above property was constructed before 1978, and there may be a possibility of lead based paint. The undersigned acknowledge that the Urban Redevelopment Authority of Pittsburgh will provide a grant covering 25% of the total cost up to $10,000 of lead hazard reduction work to be performed at the above address according to a Risk Assessment, which will be performed once my application is approved and referred to the Urban Redevelopment Authority. I also acknowledge that there is a $300.00 Lead Fee, which will be included as part of the grant for the lead hazard reduction work. I also understand that if there is any lead hazard reduction work to be done, it must be performed by a contractor who is certified to do lead reduction work. I/We hereby authorize the Urban Redevelopment Authority of Pittsburgh, its employees or its designated agent, to enter upon the above premises for the purpose of inspecting the property and preparing the specifications for lead hazard reduction and any required associated rehabilitation of the structure. _______________________________ ________________________ Borrower Date _______________________________ ________________________ Co-Borrower Date NOTIFICATION Watch Out for Lead-Based Paint Poisoning
PHRP_0_Application11-29-17.docx