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2. The Code Cash Home Improvement grant is an exclusive program to the City of Burnsville. Grants are awarded to qualified Burnsville residents to help remedy minor property code violation. Residents applying for the Code Cash Home Improvement grant must commit to a 50-50 match of the grant.

   To qualify, residents must have incurred a property maintenance code violation and have at least two of the following additional factors: 

   1) Be of socio-economic disadvantage* 

   2) Be a Senior (65+) or have a disability 

   3) Received a maintenance code violation that is a risk to life/safety

4. Household Information
6. Property Owner*

   First Name

7. Property Owner

   Middle Name

8. Property Owner*

   Last Name

10. When did you receive the code violation?*
    When did you receive the code violation?
12. What is the case number of your code violation?*
14. Property Owner Date of Birth
    Property Owner Date of Birth

    *Required if senior status if one of your qualifying factors

16. Address*
18. Email Address*
19. Best Daytime Phone Number*
21. Repairs Needed*

    Repairs can be completed by the homeowner or through a licensed contractor. Please indicate who will be completing the repairs and describe the repairs you will be addressing below. Even if you are completing the repairs yourself, please estimate the costs below.

    1. I will complete the repairs
    2. I will be hiring a licensed contractor to complete the repairs
23. Description of Repair or Improvement*
25. Cost estimate for work (Bid #1)
26. Date work is expected to begin
    Date work is expected to begin
28. Cost estimate for work (Bid #2)
29. Date work is expected to begin
    Date work is expected to begin
31. Attachments

    Attach copies of quote(s), cost estimate, and/or receipts for completion of work. 

33. Acknowledgements

    I acknowledge that I am the homeowner and meet at least two of the following factors: 1) socio-economic disadvantage; 2) senior (65+) or have a disability; or 3) received a maintenance code violation that is a risk to life/safety.

    I acknowledge that if approved, funds will not be released until the project is completed and inspected, that the property is currently owner-occupied, is eligible for a one-time only grant and that the owner is responsible for any other charges including tax or liens associated with the repair or improvement.

    The City retains the right to ask for additional information and may suspend or withdraw grant monies at any time if the applicant does not follow requirements or provides false information. 

35. Property Owner Signature*
36. Date of Signature*
    Date of Signature
38. Disclaimer

    Socio-economic disadvantage applies to people having a disadvantaged social status or disadvantaged economic status, including new Americans, migrants, non-English speakers, low income earners; or lack of or low-level educational qualifications, or other financial stresses.

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40. 1. Receive an email copy of this form.
41. Email address

    This field is not part of the form submission.

42. Submit

* indicates a required field