Housing Rehab Interest Form

Preliminary Application for Owner-Occupied Housing Rehab

Applicant Name(Required)

Co-Applicant Name

Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

Phone Number(Required)

Provide the best phone number to reach you at

Optional, but preferred

Number of People living in household(Required)

Enter the number of people living in the household - include children and adults.

Annual Gross Household Income(Required)

Enter the Gross Annual Household Income for all household members.

Thank you for your PRE-APPLICATION submission. A full application will be sent as a follow-up. For more information please contact SEMMCHRA at 651-565-2638.

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Housing Rehab Contacts:

Sara Fuher
Grant Adminstrator
651-565-2638 ext. 221
sara.fuher@semmchra.org

Patrick Michener
Grant Writer
651-565-2638 ext.213
pmichener@semmchra.org

SEMMCHRA
134 East Second Street
Wabasha, MN 55981

Community Development Applications:

Grant Writing Application

GOODHUE COUNTY Trust Fund and SAHA Application

Housing Rehab Interest Form

Housing Rehab Interest Form