Special Service Area (SSA) #51 Chatham Cottage Grove Public Way Business Survey 2015
Public Way Aesthetics Survey Plan
SURVEY COMPLETED BY
DATE
BUSINESS OWNER INFORMATION
BUSINESS/COMPANY NAME *
TYPE OF BUSINESS
Is this the business owner, taxpayer, both or other?
Clear selection
BUSINESS OWNER NAME *
BUSINESS ADDRESS *
BUSINESS ZIPCODE *
BUSINESS TELEPHONE NUMBER *
BUSINESS FAX NUMBER
BUSINESS EMAIL *
BUSINESS WEBSITE
TAXPAYER INFORMATION
NAME OF TAXPAYER/BUILDING OWNER
TAXPAYER ADDRESS
TAXPAYER ZIP CODE
TAXPAYER TELEPHONE NUMBER
TAXPAYER FAX NUMBER
TAXPAYER EMAIL
TAXPAYER WEBSITE
SURVEY QUESTIONS
Please answer each question to the best of your ability.
Q1.0 Did you know that your business is located in the Chatham Cottage Grove SSA #51 Business District and as a result your business is eligible for special services? *
Required
Q2.0 Did you know that your business can be eligible for Public Way Aesthetics? i. e. decorative planters, trash receptacles, outdoor standing ashtray *
Required
PUBLIC WAY SURVEY SIGNATURE *
By printing your name, you confirm that PWA information confirmation of intent and understand put efforts in motion that will not be changed during term of SSA#51.
Q3.0 Do you currently have security cameras or equipment that monitors activity inside your business? *
Required
Q4.0 If so, are you aware of the City of Chicago’s Office of Emergency Management Services Private Initiative for businesses available to you? *
Required
Q5.0 Would you like to have a garbage can installed outside of your business? *
Required
Q6.0 Would you like to have a Outside Ashtray installed outside of your business? *
Required
Q7.0 Would you like a planter placed infront of your business? *
Required
Q8.0 Do you know what a TIF is? *
Required
Q9.0 Do you know what a SBIF Grant is? *
Required
Q10.0 DO YOU KNOW WHAT THE FACADE ENHANCEMENT GRANT IS? *
Required
Q11.0 If interested, you can schedule a meeting with a CBA representative to discuss the TIF, SBIF and the Facade Enhancement Program. *
Q12.0 Is there any additional information on resources that you would like to have? *
Required
Q13.0 If yes, what information would you like to receive?
Q14.0 Can an SSA #51 representative for Chatham Business Association SBDI (service provider for SSA#51) take pictures of your business? *
Required
Required Signature (Online please initial) *
By Signing the Below, I acknowledge the following: 1. This survey has been created and administered by SSA#51 Service Provider to its Property Owners and Businesses for the Purpose of soliciting recommendations for aesthetic improvement with the boundaries of SSA #51. 2. All Information collected from this survey will be used to determine which aesthetic permits and improvements will be created by SSA #51 service provider using SSA#51 tax levy funds. 3. Any Change requests after cost is incurred will be the responsibility of the property/business owner.
ADDITIONAL NOTES OR COMMENTS *
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