Notice Of Intent Submission

Name of Project

I am applying for

Acquisition Type

Address of Property

Street Address

City

Zip Code

How many parcels

Charleston County Parcel Identification Number (Separate with commas for multiple)

Total Acres

Total Greenbelt Funds Requested

Is This a Reimbursement Request

Yes

No

Would you like to schedule a pre-application meeting?

Yes

No

Briefly Describe your Project

Email Address

Name of Eligible Greenbelt Fund Recipient Organization Seeking Funding

Mailing Address

Street Address/P.O Box

City

State

Zip Code

Phone

I hereby certify that I am the Authorized Agent seeking Greenbelt Funding:

Print Name

Position Title

Signature

Date

NOTICE OF INTENT TO SUBMIT APPLICATION FOR CHARLESTON COUNTY GREENBELT FUNDING