Notification to the Continuum of Care (CoC) and County/Tribal Human Services Form
Instructions: This notification form is required for applicants with projects that are considered Partially Supportive Housing (less than 50% of the total units will serve High Priority Homeless (HPH), People with Disabilities (PWD), or *other homeless households). The applicant completes Sections A and B and sends it to the CoC Coordinator and the county or tribal human services office so that they are aware of the proposed units in their community. Refer to the CoC contact information on subsequent pages. 

Applicants must also submit this completed form in the Multifamily Application Portal.

Note that applicants with projects that are considered Primarily Supportive Housing (50% or more of the total units will serve HPH, PWD, or *other homeless households) must complete the CoC Confirmation Form and should not use this notification form.

A.	General Information	
Continuum of Care Region	     	
Developer/Applicant Organization	     	
Name of Proposed Project	     	
Project Location	     	

B.	Unit Information	All Units	HPH Units	PWD Units	
Total Number of Units	     	     	     	
Number of Units by Size
(SRO, Eff, 1 BR, etc.)	SRO 	     	     	
	Eff	     	     	
	One BR 	     	     	
	Two BR	     	     	
	Three BR	     	     	
	Four or more BR	     	     	

Key: HPH = High Priority Homeless; PWD = People with Disabilities; SRO = Single Room Occupancy; Eff = Efficiency; BR = Bedroom

*Other Homeless Households include individuals leaving institutions that do not have a permanent residence or other Homeless populations not referred by the Coordinated Entry System.

OPTIONAL: Other relevant project or supportive housing specific information (for example, proposed service partner, resources planned for rental assistance or service funding, etc.)
     

CoC Region	CoC Coordinator Contact Info	
Suburban Metro Area Counties (SMAC): Anoka, Carver, Dakota, Scott, and Washington Counties	Laquita Love-Limo 
SMAC coordinator 
612.707.0796 
Laquita@mesh-mn.org	
Hennepin County	Laura DeRosier
218.391.6734
Laura.DeRosier@hennepin.us 	
Ramsey County	Leigh Ann Ahmad
651.249.7690      
leigh.ahmad@co.ramsey.mn.us	
Central	Tim Poland
Central MN Housing Partnership 
320.258.0677
tpoland@cmhp.net 	
Northwest	Barbara Johnson 
Northwest CoC Coordinator
218.558.5337
barbaraj@nwmf.org 	
Northeast	Northeast MN CoC Co-Coordinators
Cara Lundquist
218.213.1306
clundquist@live.com 

Patty Beech-Dziuk 
218.525.4957
pattybeechconsulting@gmail.com	
Southeast	Jennifer Prins
River Valleys CoC
507.208.9883
jennifer.prins@rivervalleyscoc.org
	
Southwest	Jenn Lamb
Southwest Minnesota CoC Coordinator
507.530.2942
JennL@swmhp.org	
St. Louis County	Courtney Cochran 	
218.725.5158
CochranC@StLouisCountyMN.gov 	
West Central	Carla Solem
West Central MN CoC Coordinator
701.306.1944
h2hcoordinator@gmail.com