Conservation/Environment

Weatherization Loan Application


Who qualifies for a weatherization loan:

Please note that the weatherization loan program will end on Dec. 31, 2009. All new applications must be received by Nov. 13, 2009.


TELL US ABOUT YOURSELF.    (fields shown in bold are required)
First Name:   Last Name:
Home/Cell Ph:   Work Ph:   Other Ph:
E-mail address:
PUD Account# (if known):
Site Address (include city & zip):
Mailing Address (include city & zip):
Choose one: Home owner     Renter
How did you hear about this program (newspaper ad, radio ad, brochure, Web site,
word-of-mouth, etc)?
TELL US ABOUT YOUR HOME.
What type of home do you have?
 Single family residence
 Multi-family residence
Describe the style of your home (check all that apply):
 Rambler
 Manufactured Home
 Condo
 1 Story
 1-1/2 Story
 2 Story
 A-Frame
 Log Home
Check all of the following that apply to your home:
 Accessible attic
 Crawlspace
 Basement
 Slab on grade (concrete floor)
What year was the home built?
Number of stories above crawlspace or basement:
Approximate square feet:
Was your home purchased with public funds: Yes   No   Unknown
Do your bathrooms have exhaust fans? Yes   No   Unknown
Do the bathroom fans exhaust to the outside of your home? Yes   No   Unknown
Does your kitchen have an exhaust fan? Yes   No   Unknown
Does the kitchen fan exhaust to the outside of your home? Yes   No   Unknown
Does your home have knob and tube wiring? Yes   No   Unknown
Does your home have recessed lights? Yes   No   Unknown
TELL US ABOUT YOUR HEATING SYSTEM.
Check all of the following that apply to your home:
 Electric furnace    Heat pump    Gas furnace
 Electric baseboards    Air conditioner    Gas fireplace
 Electric wall heaters    Wood stove    Oil furnace
If you have a forced air heating system, where are the ducts located?
ANY ADDITIONAL INTERESTS OR CONCERNS?

By submitting this application, I authorize Chelan County PUD to verify my past and present employment earnings and any other asset balances that are needed to process my credit application. I further authorize Chelan County PUD to order a consumer credit report and verify other credit information, including, but not limited to, past and present mortgage references.