Hook-Up Case File Checklist

Grantee:  	

Grant Number:  	

Prepared by:  	

Date Prepared:  	

Owner/Investor Name:  	

Property Address:  	

			Comments	

1.	Is there an application for assistance and confirmed eligibility in the file?	
Yes	
No		

2.	
Is the applicant an:
Owner Occupant
Owner Investor		

3.	Is the
Owner Occupant
Owner Investor
Tenant {per 24 CFR Part 570.483 (b) (3)}	
LMI        Non LMI        N/A LMI        Non LMI        N/A LMI        Non LMI        N/A	

4.	Has the Grantee adopted and made public
standards for determining affordable rents, as addressed in HUD 570.483 24 CFR Ch 5 (3)?	Yes	No	Attach back-up documentation
to form.	

5.	
Indicate the type of financial assistance to the owner?
Grant
Deferred Loan
Loan	

Amount of Loan:	
Service:
Tap: Total:	

6.	Site Visit Observations	
	a.   Is there proof the Hook-up was
completed to the satisfaction of the Grantee’s Permitting and Inspections governing body?	Yes	No		
	b.   Is there evidence of hook-up or connection (I.e. water meters and/or evidence of line to the residence)	
Yes	
No		
Notes:	

_________________________________________	        _______________________
Grantee Representative				                    Date

____________________________________	        ___________________
Grant Management Representative			         Date

____________________________________	          ___________________
Grant Management Representative				  Date

Ofc. of Asst. Secy., Comm. Planning, Develop., HUD § 570.483
24 CFR Ch. V (4–1–10 Edition)
(Exerpt)
(3) Housing activities. An eligible activity carried out for the purpose of providing or improving permanent residential structures that, upon completion, will be occupied by low and moderate income households. This would include, but not necessarily be limited to, the acquisition or rehabilitation of property by the unit of general local government, a subrecipient, an entity eligible to receive assistance under section 105(a)(15) of the Act, a developer, an individual homebuyer, or an individual homeowner; conversion of nonresidential structures; and new housing construction. If the structure contains two dwelling units, at least one must be so occupied, and if the structure contains more than
two dwelling units, at least 51 percent of the units must be so occupied. If two or more rental buildings being assisted are or will be located on the same or contiguous properties, and the buildings will be under common ownership and management, the grouped buildings may be considered for this purpose as a single structure. If housing activities being assisted meet the requirements of paragraph (e)(4)(ii) or (e)(5)(ii) of this section, all such housing may also be considered for this purpose as a single structure. For rental housing, occupancy by low and moderate income households must be at affordable rents to qualify under this criterion. The unit of general local government shall adopt and make public its standards for determining ‘‘affordable rents’’ for this purpose. The following shall also qualify under this criterion:
i.	When less than 51 percent of the units in a structure will be occupied by low and moderate income households, CDBG assistance may be provided in the following limited circumstances:
a.   The assistance is for an eligible activity to reduce the development cost of the new construction of a multifamily, non-elderly rental housing project; and
b.   Not less than 20 percent of the units will be occupied by
low and moderate income households at affordable rents; and
c.	The proportion of the total cost of developing the project to be borne by CDBG funds is no greater than
the proportion of units in the project that will be occupied by low and moderate income households.
ii.	Where CDBG funds are used to assist rehabilitation delivery services or in direct support of the unit of general local government’s Rental
Rehabilitation Program authorized under 24 CFR part 511, the funds shall be considered to benefit low and moderate income persons where not less than 51 percent of the units assisted, or to be assisted, by the Rental Rehabilitation Program overall are for low and moderate income persons.
iii.	When CDBG funds are used for housing services eligible under section
105(a)(21) of the Act, such funds shall be considered to benefit low and moderate income persons if the housing units for which the services are provided are HOME-assisted and the requirements of §
92.252 or § 92.254 of this title are met.