INFORMATION WORKSHEET Name/description of organization: _______________________________ __________________________________________________________ Exact street address: _______________________________________ __________________________________________________________ Number of stories: _________________________________________ Name, address, phone of current owner/manager: _____________ __________________________________________________________ Permit date for original construction: _________________________ What Type of Organization and Possible Obligations: Business Private Title III Obligations ADA AAB Obligations  or Local Government State Title II Obligations ADA Obligations AAB Organization Religious Obligations AAB Have any renovations been done? YES NO   Permit date Dollar amount ________ $________ ________ $________ ________ $________ If renovations have been done: Tax Assessed Value (TAV) at time of permit: $________
INFORMATION WORKSHEET Name/description of organization: _______________________________ __________________________________________________________ Exact street address: _______________________________________ __________________________________________________________ Number of stories: _________________________________________ Name, address, phone of current owner/manager: _____________ __________________________________________________________ Permit date for original construction: _________________________ What Type of Organization and Possible Obligations: Private Business ADA Title III Obligations  AAB Obligations State or Local Government ADA Title II Obligations AAB Obligations Religious Organization AAB Obligations Have any renovations been done? YES  NO  Permit date Dollar amount ________ $________ ________ $________ ________ $________ If renovations have been done: Tax Assessed Value (TAV) at time of permit: $________
CAM_BOOK.docx