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, <br /> CITY OF MOUNDS VIEW <br /> INDUSTRIAL REVENUE BOND REQUEST FORM <br /> 1111 1 . Company Name Tel No . <br /> Address <br /> State of Incorporation <br /> Contact Person <br /> 2 . Type of Business <br /> Products or Services <br /> 3 . Site Location <br /> 4 . Nature of Project <br /> 5 . Current and Projected ( 5 years ) Employment <br /> Current Projected <br /> Amount of Anticipated Payroll Increase <br /> 6 . Present Gross Earning or Sales of Company <br /> IIII 7 . Projected Gross Earning or Sales of within : <br /> Two Years Within 5 Years <br /> 8 . Size of Proposed Structure or Expansion : Sq. Ft. <br /> 9 . Estimated Project Cost : Estimated Size of the issue . <br /> Land <br /> Buildings If the issue is less than <br /> Equipment estimated project cost, <br /> Other indicate balance of <br /> Special Utility Needs anticipated project funding : <br /> ( water volume , waste <br /> treatment, etc . ) <br /> TOTAL <br /> 10. Estimated additional tax revenue from project <br /> • <br /> 11 . Fiscal Consultant/Underwriter/Purchaser <br /> Address <br /> Contact Person Tel . No . <br /> III 12. Legal Counsel <br /> Address <br /> Contact Person Tel . No . <br />