N.M. Admin. Code § 4.10.2.24

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Current through Register Vol. 35, No. 21, November 5, 2024

Section 4.10.2.24 - ATTACHMENT C: PRELIMINARY LOAN APPLICATION

A. PROPERTY INFORMATION

property name:_______________

property address:____________

LOCATION

county:___________________________________ Town/City:_____________________________

historic district:____________________________

rural:____________________________________

APPLICANT

Name:_________________________________

lessee: _____ building/site owner:______________________

address:______________________________________

phone:________________________________________

social security #:________________

CO-APPLICANT

name:_______________________________ lessee:_____ building/site owner:__________

address:_____________________________

phone:_______________________________

OWNERSHIP

public___ private___ non-profit_____

name of owner (if different from above):__________________________

mailing address:_____________________________

phone:_______________________________________

taxpayer ID number:__________________________

owned/leased for _____years

Does the lease state anything about improvements? (if yes, describe)

_____________________________________________________________________________________________

PROTECTION

Is the property under legal protection such as easements or a local historic district ordinance?

Yes_____ No_____

PHOTOGRAPHS OF EACH SIDE OF THE BUILDING

Provide photographs to show all sides of the building(s) adequately. Closeup photographs showing details of the building are also recommended. Photographs must be glossy black and white, no smaller than 5 X 7 inches.

REGISTRATION Yes No

1. Is the property individually listed in

the national register of historic places? ____ ____

2. Is the property listed as contributing to

a historic district listed in the national

3. Has the property been officially

determined by the keeper of the register

to be eligible for listing in the

national register of historic places? ____ ____

If you answered "No" to 1, 2, and 3 above, please answer the following questions:

Is the property individually listed in the

state register of cultural properties? ____ ____

Is the property listed as contributing

to a historic district listed in the

state register of cultural properties? ____ ____

If you answered "No" to 1, 2, and 3 above, complete ONLY the owner's signature section below. Do not complete the remainder of this application. The historic preservation division will inform you if your property is eligible for the loan program. Please submit the completed portion of this form to the historic preservation division.

B. DESCRIPTION OF REHABILITATION/PRESERVATION WORK: In the blocks provided, provide a detailed description of the project. The block titled "description of work and impact on feature" should be used to describe in detail the work on a specific feature. Describe each feature, including a description of its present condition followed by a description of the proposed work and its impact on the feature. Attach labeled and numbered photographs (glossy black and white, no smaller than 5" X 7") of each feature. Use as many blocks as necessary to describe the entire project. Examples of features are stairways, windows, doors, roofing, chimneys, floors, exterior and interior finishes, major spaces, etc. Attach copies of additional blocks if necessary.

________________________________

architectural feature #_____; description of feature and its present condition

photo no. _____ drawing no. _____

________________________________

description of work and impact on feature:

architectural feature #_____; description of feature and its present condition

photo no. _____ drawing no. _____

________________________________

description of work and impact on feature:

architectural feature #_____; description of feature and its present condition

photo no. _____ drawing no. _____

________________________________

description of work and impact on feature:

COST ESTIMATE OF PROPOSED WORK:

To the best of your knowledge, provide an estimate of the proposed work. Itemize separate costs as nearly as possible according to the features described in the description of rehabilitation/preservation work section above.

Itemized:

total estimated project cost:_______________

ESTIMATED PROJECT STARTING DATE:____________

ESTIMATED COMPLETION DATE:__________________

OWNER'S SIGNATURE

I hereby apply for participation in the state historic preservation loan program and I attest the information I have provided is, to the best of my knowledge, correct.

____________________ date:__________

owner's signature

C. CERTIFICATION (for state use only)

The historic preservation division has reviewed this preliminary loan application and

_____approves the preliminary loan application as submitted.

_____approves the preliminary loan application with the

provisions stated below:

________________________________

________________________________.

_____rejects the preliminary loan application because the proposed work does not conform to the standards set forth in regulations pursuant to this program.

_____tables the preliminary loan application and requests the following additional information before the application will be reviewed:

________________________________

________________________________.

_______________________ date:__________

division staff reviewer

_______________________ date:__________

state historic preservation officer

N.M. Admin. Code § 4.10.2.24

7/16/97; 4.10.2.24 NMAC - Rn, 4 NMAC 10.2.24, 1/1/08