Loading...
Request for Release of Funds for Lead-Based Paint Hazard Control GrantCity of Dubuque City Council Meeting Consent Items # 18. Copyrighted January 18, 2022 ITEM TITLE: Request for Release of Funds for Lead -Based Paint Hazard Control G rant SUMMARY: City Manager recommending authorization to execute the Request for Release of Funds and Certification for the Lead -Based Paint Hazard Control Grant at the close of the required public comment period and upon successful resolution of all comments received by the public. RESOLUTION Authorizing the Request for Release of Funds for the 2021-2025 Lead Hazard Control and Healthy Homes Grant #IALHB0773-21 SUGGESTED Suggested Disposition: Receive and File; Adopt Resolution(s) DISPOSITION: ATTACHMENTS: Description Type Lead -Based Paint Hazard Control Grant-MVM Memo City Manager Memo Request for Release of Funds 21 Lead Grant - Staff Staff Memo Memo Request for Release of Funds 21 Lead Grant - Resolutions Resolution Tier I Environmental Review Supporting Documentation Request for Release of Funds - 2021 Lead Grant Supporting Documentation THE CITY OF Dubuque DUB TEE1. All -America City Masterpiece on the Mississippi � pp zoo�•*o 13 zoi720zoi9 TO: The Honorable Mayor and City Council Members FROM: Michael C. Van Milligen, City Manager SUBJECT: Request for Release of Funds for Lead -Based Paint Hazard Control Grant #IALHB0773-21 DATE: January 11, 2022 Housing and Community Development Director Alexis Steger is transmitting the Request for Release of Funds for the Lead -Based Paint Hazard Control Grant. The City was awarded $4,275,680.92 from HUD's Office of Lead Hazard Control and Healthy Homes to provide health and safety interventions in 106 rental and owner -occupied properties. The City of Dubuque has also committed to providing $686,417 in Match, for a total amount of $4,962,097.92. The City of Dubuque must complete an Environmental Review and submit a Request for Release of Funds to HUD's Office of Lead Hazard Control and Healthy Homes prior to expending funds from this grant for non-exempt activities. Alexis Steger recommends City Council authorization to execute the Request for Release of Funds and Certification at the close of the required public comment period and upon successful resolution of all comments received by the public. I concur with the recommendation and respectfully request Mayor and City Council approval. v Mic ael C. Van Milligen MCVM:jh Attachment cc: Crenna Brumwell, City Attorney Cori Burbach, Assistant City Manager Alexis M. Steger, Housing and Community Development Director Dubuque THE CITY OF AII•Americs city DUB E i nx 2007�2012�2013 Masterpiece on the Mississippi 2017*2019 TO: Michael C. Van Milligen, City Manager FROM: Alexis M. Steger, Housing and Community Development Director SUBJECT: Request for Release of Funds for Lead -Based Paint Hazard Control Grant #IALHB0773-21 DATE: January 10, 2022 Introduction This memorandum transmits the Request for Release of Funds for the Lead -Based Paint Hazard Control Grant #IALHB0773-21. The City was awarded $4,275,680.92 from HUD's Office of Lead Hazard Control and Healthy Homes to provide health and safety interventions in 106 rental and owner -occupied properties. The City of Dubuque has also committed to providing $686,417 in Match, for a total amount of $4,962,097.92. In accordance with 24 CFR Part 58, the City of Dubuque must complete an Environmental Review and submit a Request for Release of Funds to HUD's Office of Lead Hazard Control and Healthy Homes prior to expending funds from this grant for non-exempt activities. Discussion A Tier I Environmental Review has been completed for the Lead Hazard Control and Healthy Homes activities that will be performed under this grant. Individual site -specific reviews will be completed for each project to document compliance with all required laws and authorities listed in 24 CFR Part 58 that did not achieve broad -level compliance with the Tier I review. The City of Dubuque intends to publish a Notice of Intent to Request Release of Funds (NOI/RROF) on January 19, 2022. This notice will be followed by a seven-day comment period to allow for citizen and public agency comments on the Tier I Environmental Review for this program. After the public comment period ends and all comments have been addressed, the Certifying Officer for the City of Dubuque can authorize the Request for Release of Funds to be submitted to HUD, who then requires a 15-day review period before releasing an Authorization for the Use of Grant Funding. Recommendation I respectfully request the City Council authorizes the Certifying Officer to execute the Request for Release of Funds and Certification (HUD 7015.15) at the close of the required public comment period and upon successful resolution of all comments received by the public. Prepared by: Maddy Haverland, Community Development Specialist Prepared by Maddv Haverland Housing & Community Devel 350 W. 611 St Suite 312 Telephone: (563) 690-6072 Return to Adrienne N. Breitfelder, City Clerk, 50 W. 1311 St., Dubuque, IA 52001, (563) 589-4100 RESOLUTION NO. 17-22 RESOLUTION AUTHORIZING THE REQUEST FOR RELEASE OF FUNDS FOR THE 2021-2025 LEAD HAZARD CONTROL AND HEALTHY HOMES GRANT #IALHB0773- 21 Whereas, the City of Dubuque applied for, and was awarded a Lead Hazard Control and Healthy Homes grant in the amount of $4,275,681 for the performance period of November 1, 2021 — May 30, 2025; and Whereas, a Tier I Environmental Review has been completed, pursuant to 24 CFR Part 58 for lead hazard control activities and healthy homes interventions; and Whereas, notification of a seven-day comment period to allow for citizen and public agency comments on the Tier I Environmental Review for this program will be published, and all comments satisfactorily resolved prior to submitting the Request for Release of Funds. NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF DUBUQUE, IOWA: Section 1. That the Request for Release of Funds attached hereto, shall be approved upon the completion of the public comment period and resolution of all comments. Section 2. The Certifying Officer is hereby authorized to direct staff to publish the Notice of Intent of Request for Release of Funds for the 2021 Lead and Healthy Homes Grant and authorize the Request for Release of Funds upon successful resolution of all public comments. Passed, approved, and adopted this 18th day of January 2022. ��� Attest e� dyn.Q E.�A Adrienne N. Breitfelder, City Clerk QPPtME"roFy U.S. Department of Housing and Urban Development 451 Seventh Street, SW oG IIIIIIII Washington, DC 20410 9e4ro o'77 WWW.hud.goV espanol.hud.gov Tiered Environment Review for Activity/Project that is Categorically Excluded Subject to Section 58.5 Pursuant to 24 CFR 58.35(a) Project Information Project Name: City-of-Dubuque-2021-Lead-&-Healthy-Homes HEROS 900000010234074 Number: Responsible Entity DUBUQUE, CITY HALL DUBUQUE IA, 52001 (RE): State / Local Identifier: RE Preparer: Kelly Davis Certifying Officer: Grant Recipient (if different than Responsible Entity): Point of Contact: Consultant (if applicable): Point of Contact: Project Dubuque, IA 52001 Location: Additional Location Information: The project eligibility area for residential homes to participate in the Lead and Healthy Homes program is the entire city of Dubuque, Iowa. See attached map. City-of-Dubuque-2021- Dubuque, IA 900000010234074 Lead-&-Healthy-Homes Direct Comments to: Description of the Proposed Project [24 CFR 50.12 & 58.32; 40 CFR 1508.25]: The City of Dubuque will utilize the Lead -Based Paint Hazard Control and Healthy Homes Supplemental funding for administration and production costs for the performance period of February 1, 2022 through June 30, 2026. The HUD -funded amount for these activities totals $4,275,681. Activities will include staff salaries and fringes, marketing and recruitment, supplies, equipment, testing, mitigation/remediation of hazards, and clearances associated with lead hazard control work and healthy homes interventions. A total of 106 existing owner -occupied and/or rental units housing low -moderate income individuals and families will receive assistance in making their built environments safer and healthier. Eligibility for rental units is based on the tenant. All projects covered under this Environmental Review will be completed on single-family homes or buildings containing one to four units constructed prior to 1978. The area of eligibility for participation in this project is the entire city of Dubuque, including structures located in the 100-year floodplain (Special Flood Hazard Area). Preference will be given to homes housing a child under the age of six, a pregnant woman, or having a child under the age of 6 who visits at least 10% of the time. For 20 historic units, the average cost per project will be $40,000 for lead hazard control with a supplemental average of $4,372 per project for healthy homes interventions. For 86 other pre-1978 units, the average cost per project will be $16,000 for lead hazard control with a supplemental average of $4,500 per project for healthy homes interventions. Funds will be disbursed in the form of a three-year forgivable loan to the property owner. The scope of work for this project will be primarily minor rehabilitation focused on controlling lead -based paint and health or safety hazards. Most common interventions including window replacement, paint stabilization, enclosure of components (soffits, fascia, siding, casings, etc.), and replacement of damaged or unserviceable substrates. Healthy Homes interventions may include installation of radon mitigation systems, mechanically exhausted ventilation systems, installation of hard -surface flooring, remediation of tripping or fall hazards, or other minor interventions to improve the health and safety of the unit. There will be no ground disturbance in the projects covered by this review. Community Development Block Grant (CDBG) funding in the amount of $300,000 will be utilized as match with this grant program to complete lead hazard control in 20 units at an average of $15,000 per unit. A separate Environmental Review will be completed for each of the projects funded by CDBG. Program income of 5% (for historic properties) or 10% (for non-NRE properties) of the total project costs from owner contributions for rental units will also be used for direct project costs. Other match costs total to $686,417, bringing the total funds for this project to $4,962,098. Maps, photographs, and other documentation of project location and description: CityLimits2019.pdf Approximate size of the project more than 1 square mile area: Length of time covered by this 4 Years review: Maximum number of dwelling units or lots addressed by this tiered review: 106 Version 11.07.2012 01/10/2022 16:38 Page 2 of 7 City-of-Dubuque-2021- Dubuque, IA Lead-&-Healthy-Homes 900000010234074 Level of Environmental Review Determination: Categorically Excluded per 24 CFR 58.35(a), and subject to laws and authorities at §58.5: 58.35(a)(3) Determination: Extraordinary circumstances exist and this project may result in significant environmental impact. This project requires preparation of an Environmental Assessment (EA); OR ✓ There are no extraordinary circumstances which would require completion of an EA, and this project may remain CEST. Approval Documents: 7015.15 certified by Certifying Officer on: 7015.16 certified by Authorizing Officer on: Funding Information Grant Number HUD Program Program Name IALHBO773-21 Healthy Homes and Lead Hazard Control Estimated Total HUD Funded $4,275,681.00 Amount: Estimated Total Project Cost [24 CFR 58.2 (a) $4,962,098.00 (5)): Compliance with 24 CFR §50.4, §58.5 and §58.6 Laws and Authorities Compliance Factors: Was compliance Describe here compliance Statutes, Executive Orders, and achieved at the determinations made at the broad level Regulations listed at 24 CFR §50.4, broad level of and source documentation. §58.5, and §58.6 review? STATUTES, EXECUTIVE ORDERS, AND REGULATIONS LISTED AT 24 CFR §50.4 & § 58.6 Airport Hazards Q Yes ❑ No Proposed project is in compliance with Clear Zones and Accident Potential Zones and 24 CFR Part 51 Subpart D because project does not include the Version 11.07.2012 01/10/2022 16:38 Page 3 of 7 City-of-Dubuque-2021- Dubuque, IA Lead-&-Healthy-Homes 900000010234074 purchase or sale of property/land. The Dubuque Regional Airport is outside the city limits, and none of the structures located in the clear zone are eligible for activities within the proposed project. See attached clear zone map and map showing the location of the airport in relation to the city. Coastal Barrier Resources Act Q Yes ❑ No Proposed project is in compliance with CBRA because there are no Coastal Barriers in the city of Dubuque, or entire state of Iowa. See attached map. Flood Insurance ❑ Yes Q No STATUTES, EXECUTIVE ORDERS, AND REGULATIONS LISTED AT 24 CFR §50.4 & § 58.5 Air Quality Q Yes ❑ No Proposed project will not provide for any new construction or conversion of use (i.e. nonresidential to residential). Therefore, the program is in compliance wit the Clean air Act without any evaluation at the site -specific level. Coastal Zone Management Act Q Yes ❑ No Proposed project is in compliance with the Coastal Zone Management Act, because there are no coastal zones in Dubuque, Iowa. See attached NOAA info sheet; map on page 2. Contamination and Toxic ❑ Yes Q No Substances Endangered Species Act Q Yes ❑ No This program will be limited to minor rehabilitation of existing residential structures. Therefore, it is in compliance with the Endangered Species Act and no further site -specific evaluation is required. Explosive and Flammable Hazards Q Yes ❑ No This project does not include development, construction, rehabilitation that will increase residential densities, or conversion. This project does not include a hazardous facility. Farmlands Protection Q Yes ❑ No This program will not provide for any new construction or acquisition of undeveloped land. Therefore, it is in compliance with Farmlands Protection and no further site -specific evaluation is required. Version 11.07.2012 01/10/2022 16:38 Page 4 of 7 City-of-Dubuque-2021- Dubuque, IA Lead-&-Healthy-Homes 900000010234074 Floodplain Management Q Yes ❑ No Only a small portion of structures in the City of Dubuque are located in the 100- year floodplain. For each site -specific review, the RE will consult FEMA floodplain maps to determine if the property is within the 100-year floodplain or designated as a Special Flood Hazard Area. The RE will create a FIRMette and document the floodplain zone designation, panel number, and date of the designation to keep in the ERR. If the structure is not located in a Special Flood Hazard Area, the RE will maintain the FIRMette and supporting documentation in the ERR and proceed with the project. Historic Preservation ❑ Yes Q No Noise Abatement and Control Q Yes ❑ No This program will not provide for any new construction or major rehabilitation. Therefore, it is in compliance with Noise Abatement and Control without site -specific noise analysis. Additionally, some Lead Hazard Control and Healthy Homes intervention activities have an unintended consequence of noise attenuation, i.e., window/exterior door replacement, wall/ceiling insulation, sealing of cracks and holes. Sole Source Aquifers 0 Yes ❑ No This program is limited to minor rehabilitation of existing residential structures. Therefore, it is in compliance with the Safe Drinking Water Act. Additionally, there are no Sole Source Aquifers in the city of Dubuque, which is the range covered by this review. See attached map from the EPA's website. Wetlands Protection ✓❑ Yes ❑ No Proposed activities are exclusively to existing structures and there will be no ground disturbance or land development with these projects. Wild and Scenic Rivers Act Q Yes ❑ No This program is limited to minor rehabilitation of existing residential buildings. Therefore, it is in compliance with Wild and Scenic Rivers Act. No site - specific evaluation is required. Additionally, there are no Wild and Version 11.07.2012 01/10/2022 16:38 Page 5 of 7 City-of-Dubuque-2021- Dubuque, IA Lead-&-Healthy-Homes 900000010234074 Scenic Rivers in the city of Dubuque, which is the range covered by this review. See attached map from the National Wild and Scenic Rivers website. ENVIRONMENTAL JUSTICE Environmental Justice Q Yes ❑ No This program consists of minor rehabilitation in order to improve the health and safety of low/moderate income occupants. Due to the nature of the program, there is no disproportionate adverse environmental impact to minority or low/moderate income persons, populations or neighborhoods. Supporting documentation No CBRAs in Dubuaue - CBRS Manner.ndf czm-fact-sheet.pdf 5-Step Process 122821.pdf No Sole Source Aquifers in Dubuque.pdf No Wild and Scenic Rivers in Dubuque.pdf DBQ airport location.JPG DBQ Airport Clear Zones.pdf Written Strategies The following strategies provide the policy, standard, or process to be followed in the site - specific review for each law, authority, and factor that will require completion of a site -specific review. 1 Flood Insurance The Flood Disaster Protection Act of 1973 (42 U.S.C. 4012a) requires that projects receiving HUD assistance in a FEMA-mapped SFHA be covered by flood insurance under the National Flood Insurance Program (NFIP). All site -specific reviews must include a FEMA FIRM map with the project site clearly marked. If the project structures are located in a FEMA Special Flood Hazard Area (SFHA), the project must provide proof of flood insurance in, minimally, the total project cost (less the estimated land cost) or to the maximum limit of coverage made available by the NFIP. This may be either a copy of the flood insurance policy declaration or a paid receipt for the current annual flood insurance premium and a copy of the application for flood insurance. Note that HUD may not provide assistance to SFHA sites in communities that are not participating or in good standing in the NFIP. A copy of the flood insurance policy declaration will be maintained in the ERR, and the project will proceed. The funding in the proposed project is disbursed in the form of a 3-year forgivable loan, therefore the RE will request a copy of the policy declaration annually for the life of the loan to be maintained in the ERR. 2 Contamination and Toxic Substances Version 11.07.2012 01/10/2022 16:38 Page 6 of 7 City-of-Dubuque-2021- Dubuque, IA Lead-&-Healthy-Homes 900000010234074 The Flood Disaster Protection Act of 1973 (42 U.S.C. 4012a) requires that projects receiving HUD assistance in a FEMA-mapped SFHA be covered by flood insurance under the National Flood Insurance Program (NFIP). All site -specific reviews must include a FEMA FIRM map with the project site clearly marked. If the project structures are located in a FEMA Special Flood Hazard Area (SFHA), the project must provide proof of flood insurance in, minimally, the total project cost (less the estimated land cost) or to the maximum limit of coverage made available by the NFIP. This may be either a copy of the flood insurance policy declaration or a paid receipt for the current annual flood insurance premium and a copy of the application for flood insurance. Note that HUD may not provide assistance to SFHA sites in communities that are not participating or in good standing in the NFIP. A copy of the flood insurance policy declaration will be maintained in the ERR, and the project will proceed. The funding in the proposed project is disbursed in the form of a 3-year forgivable loan, therefore the RE will request a copy of the policy declaration annually for the life of the loan to be maintained in the ERR. 3 Historic Preservation For each site -specific review, the RE will research and compile information about the project and make a determination to submit to the Iowa State Historic Preservation Office for comment. The RE will review the scope of the work and use photos, maps, surveys, and other available information to determine the Area of Potential Effect and come to a determination whether historic properties are affected. The determination and supporting documentation will be uploaded to the Iowa SHPO online review system for request for comment. If SHPO responds with concurrence within the 30-day period, the RE will add the documentation to the ERR and proceed with the project. If SHPO requests more information, the RE will research and compile the requested documentation and re -submit to the SHPO for further review. When concurrence is reached, the RE will add the documentation to the ERR and proceed with the project. If SHPO does not respond with comment within the 30-day comment period, the RE will maintain record that the comment period has passed and the project will proceed. In the event that the SHPO enters into a programmatic agreement or Letter of Understanding with the RE, the documentation of terms and the date of the agreement/letter will be maintained in the ERR. Supporting documentation Tiered ER Site Specific Review Lead 21 Grant.pdf APPENDIX A: Site Specific Reviews Version 11.07.2012 01/10/2022 16:38 Page 7 of 7 Request for Release of Funds U.S. Department of Housing OMB No.2506-0087 and Urban Development (exp. 03/31/2020) and Certification Office of Community Planning and Development This form is to be used by Responsible Entities and Recipients (as defined in 24 CFR 58.2) when requesting the release of funds, and requesting the authority to use such funds, for HUD programs identified by statutes that provide for the assumption of the environmental review responsibility by units of general local government and States. Public reporting burden for this collection of information is estimated to average 36 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. This agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless that collection displays a valid OMB control number. Part 1. Program Description and Request for Release of Funds (to be completed by Responsible Entity) 1. Program Title(s) 2. HUD/State Identification Number 3. Recipient Identification Number Lead -Based Paint Hazard Control & Healthy Homes Supplemental Grant IALH BO773-21 (optional) 4. OMB Catalog Number(s) 5. Name and address of responsible entity 14.900 City of Dubuque 6. For information about this request, contact (name & phone number) 350 W. 6th St, Suite 312 Alexis Steger, 563.589.4239 Dubuque, IA52001 8. HUD or State Agency and office unit to receive request 7. Name and address of recipient (f different than responsible entity) US Department of Housing and Urban Development Office of Lead Hazard Control and Healthy Homes 451 7th Street, S.W., 8236, Washington DC 20410 ATTN: Matthew Ammon, Director The recipient(s) of assistance under the program(s) listed above requests the release of funds and removal of environmental grant conditions governing the use of the assistance for the following 9. Program Activity(ies)/Project Name(s) 10. Location (Street address, city, county, State) 2021 City of Dubuque Lead Hazard Control and 350 W 6th St, Suite 312 Healthy Homes Program City of Dubuque, Dubuque County, Iowa 11. Program Activity/Project Description The City of Dubuque will utilize the Lead -Based Paint Hazard Control and Healthy Homes Supplemental funding for administration and production costs for the performance period of February 1, 2022 through June 30, 2026. The HUD -funded amount for these activities totals $4,275,681. Activities will include staff salaries and fringe benefits, marketing and recruitment, supplies, equipment, testing, mitigation/remediation of hazards, and clearances associated with lead hazard control work and healthy homes interventions. Up to 120 existing owner -occupied and/or rental units housing low -moderate income individuals and families will receive assistance in making their built environments safer and healthier. Eligibility for rental units is based on the tenant. All projects covered under this Environmental Review will be completed on single-family homes or buildings containing one to four units constructed prior to 1978. The area of eligibility for participation in this project is the entire city of Dubuque, including structures located in the 100-year floodplain (Special Flood Hazard Area). Preference will be given to homes housing a child under the age of six, a pregnant woman, or having a child under the age of 6 who visits at least 10% of the time. Approximately 20 historic units with an average cost per project of $40,000 for lead hazard control with a supplemental average of $4,372 per project for healthy homes interventions will be completed. Up to 100 other pre-1978 units, the average cost per project will be $16,000 for lead hazard control with a supplemental average of $4,500 per project for healthy homes interventions. Funds will be disbursed in the form of a three-year forgivable loan to the property owner. The scope of work for this project will be primarily minor rehabilitation focused on controlling lead -based paint and health or safety hazards. Most common interventions including window replacement, paint stabilization, enclosure of components (soffits, fascia, siding, casings, etc.), and replacement of damaged or non -serviceable substrates. Healthy Homes interventions may include installation of radon mitigation systems, mechanically exhausted ventilation systems, installation of hard -surface flooring, remediation of tripping or fall hazards, or other minor interventions to improve the health and safety of the unit. There w ll be no ground disturbance in the projects covered by this review. Community Development Block Grant (CDBG) funding in the amount of $300,000 will be utilized as match with this grant program to complete lead hazard control in 20 units at an average of $15,000 per unit. A separate Environmental Review will be completed for each of the projects funded by CDBG. Other match costs total to $686,417, bringing the total funds for this project to $4,962,098. Previous editions are obsolete form HUD-7015.15 (1199) Part 2. Environmental Certification (to be completed by responsible entity) With. reference to the above Program Activity(ies)/Project(s), I, the undersigned officer of the responsible entity, certify that: 1. The responsible entity has fully carried out its responsibilities for environmental review, decision -making and action pertaining to the project(s) named above. 2. The responsible entity has assumed responsibility for and complied with and will continue to comply with, the National Environmental Policy Act of 1969, as amended, and the environmental procedures, permit requirements and statutory obligations of the laws cited in 24 CFR 58.5; and also agrees to comply with the authorities in 24 CFR 58.6 and applicable State and local laws. 3. The responsible entity has assumed responsibility for and complied with and will continue to comply with Section 106 of the National Historic Preservation Act, and its implementing regulations 36 CFR 800, including consultation with the State Historic Preservation Officer, Indian tribes and Native Hawaiian organizations, and the public. 4. After considering the type and degree of environmental effects identified by the environmental review completed for the proposed project described in Part 1 of this request, I have found that the proposal did ❑ did not ❑✓ require the preparation and dissemination of an environmental impact statement. 5. The responsible entity has disseminated and/or published in the manner prescribed by 24 CFR 58.43 and 58.55 a notice to the public in accordance with 24 CFR 58.70 and as evidenced by the attached copy (copies) or evidence of posting and mailing procedure. 6. The dates for all statutory and regulatory time periods for review, comment or other action are in compliance with procedures and requirements of 24 CFR Part 58. 7. In accordance with 24 CFR 58.71(b), the responsible entity will advise the recipient (if different from the responsible entity) of any special environmental conditions that must be adhered to in carrying out the project. As the duly designated certifying official of the responsible entity, I also certify that: 8. I am authorized to and do consent to assume the status of Federal official under the National Environmental Policy Act of 1969 and each provision of law designated in the 24 CFR 58.5 list of NEPA-related authorities insofar as the provisions of these laws apply to the HUD responsibilities for environmental review, decision -making and action that have been assumed by the responsible entity. 9. I am authorized to and do accept, on behalf of the recipient personally, the jurisdiction of the Federal courts for the enforcement of all these responsibilities, in my capacity as certifying officer of the responsible entity. Signature of Certifying Officer of the Responsible Entity Title of Certifying Officer Housing & Community Development Director Date signed X o Address of Certifying 350 W. 6th Street, Suite 312, Dubuque, IA 52001 Part 3. To be completed when the Recipient is not the Responsible Entity The recipient requests the release of funds for the programs and activities identified in Part 1 and agrees to abide by the special conditions, procedures and requirements of the environmental review and to advise the responsible entity of any proposed change in the scope of the project or any change in environmental conditions in accordance with 24 CFR 58.71(b). Signature of Authorized Officer of the Recipient X Title of Authorized Officer Date signed Warning: HUD will prosecute false claims and statements. Conviction may result in criminal and/or civil penalties. (18 U.S.C. 1001, 1010, 1012; 31 U.S.C. 3729, 3802) Previous editions are obsolete form HUD-7015.15 (1199)