| Company / Project Name: |
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| Company Contact Name: |
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| Phone: |
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| Project Management: Contact Name: |
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| Phone: |
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| Mailing Address: |
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| Physical Address of Project: |
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| Tax Map No (Section/Block/Lot): |
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| Lease or Own Facility |
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| If leasing, provide name of owner: |
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| Type of Company: (example: manufacturer of shoes, auto service etc.) |
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| Total Building Square Footage: |
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| Percentage of Occupancy of Building: |
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| Total Project Investment $: |
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| Total Employees: |
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| Retained: |
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| New: |
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| Will you hire locally (Orange County residents) or from an outside source?
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| Type of Jobs to be created (please be specific ex: 1 manager, 2 admin etc.)
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| Please list all municipalities and agencies that must provide approvals for the proposed project:
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If an application is pending in any municipality for approval related to the proposed project,
please identify the municipality, the type of application, and the status of the application:
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Please give a brief description about the project, what types of goods or services will be
created, and why the benefits you are seeking are important to the project:
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