Clearance Desk Review Monitoring Form

Clearance Desk Review Monitoring Form

Clearance is an activity that can be used in conjunction with both reconstruction and relocation or as an activity by itself. (Bulletin 10-2)

Grantee:

Grant Number:

Prepared by:

Date Prepared:

Telephone Number:

Email Address:

Owner’s Name:

Property Address:

Comments
1. / Use of property at date of clearance (check one): / Owner-occupied residential Tenant-occupied residential Vacant residential (< one year) Vacant residential (> one year) Commercial/Storage
2. / Was this unit occupied, vacant (< one year), or
vacant and occupiable (per CDBG Bulletin 94-1)
cleared? If yes, answer questions 2a through 2c. / Yes / No
a) Did the grantee make the following information
public:
(Attach copy of documentation) / Yes / No
1. A description of the proposed assisted
activity? / Yes / No
2. Location on a map of unit cleared? / Yes / No
3. The schedule for demolition? / Yes / No
4. Location on a map for the replacement
unit? / Yes / No
5. The source of funding and schedule for
the provision of the replacement unit? / Yes / No
6. The basis to contend the replacement unit
will remain LMI for 10 years? / Yes / No
b) When did the Grantee obligate funds for the clearance of this unit?
(Attach documentation)
Is this prior to making public the information in
2 (a)?
(Attach documentation) / Yes / No
c) Was the replacement unit complete by the date of the clearance monitoring?
(Attach documentation) / Yes / No
3. / Was this unit vacant-not suitable for rehabilitation? / Yes / No / If yes, go to Question #3a.
a)  Does the file contain documentation of a determination that the unit is not suitable for rehabilitation (per CDBG Bulletin 94-1)?
(Attach documentation) / Yes / No
4. / Is the parcels/lots cleared of debris? (Note any problems or concerns.)
(Submit Pictures) / Yes / No
Notes:

*List or attach supporting documentation or notate items reviewed to support work performed where deemed necessary for all questions listed on this monitoring checklist.

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Grantee Representative Date

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Grant Management Representative Date