Building Standards Waiver Request Form
	
PROJECT INFORMATION  	
Project/Development Name: 
     	
Project City: 
     	Date:
     	
Owner/Developer/Borrower: 
     	Architect of Record: 
     	
Request Prepared By (individual and entity): 
     	General Contractor (if known): 
     	
Construction Type: 
 New Construction	 Substantial/Gut Rehab	 Moderate Rehab	 Adaptive Reuse	
WAIVER REQUEST INFORMATION  	
Which building standard is this request for: 
 Rental Housing Design/Construction Standards
 Architect’s Guide
 Limited Scope Abbreviated Standards 
 Environmental Standards	
 MN Overlay/Enterprise Green Communities
 Contractor’s Guide
 Limited Scope Sustainability Standards
 Other:      	
Chapter; Section; Item; Sub-Item (optional): 
     	If Green Communities, which mandatory criteria:
Number:      
Title:      	
Explain current standard, criteria, or requirement: 
     	
Indicate why the project cannot meet this standard, criteria, or requirement: 	
 Hardship due to existing conditions
 In conflict with local, state, or federal codes or regulations 
Explain:      	 Impractical due to tenant/resident population
 Other
	
NOTE: Cost hardship is typically not considered a valid reason for a waiver; however, if the waiver request is due to cost hardship, what is the cost differential? 
     	
Other Comments:      	
APPLICANT CERTIFICATION	
I hereby certify that the information contained in this waiver request is true, correct, and complete.	
Printed Name: 
     	Signature: 
     	

WAIVER DECISION (to be completed by Minnesota Housing staff) 	
 Rejected/Not Approved
 Accepted/Approved	 Approved with the following conditions:      

Minnesota Housing staff comments:      	
By (name of Minnesota Housing staff):      	Date: