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0 OP <br /> APPLICATION FOR OMB Approval No. 0348 -0043 <br /> FEDERAL ASSISTANCE 2. DATE SUBMITTED Applicant Identifier <br /> r April 23, 2007 <br /> 1. TYPE OF SUBMISSION: 3. DATE RECEIVED BY STATE State Application Identifier <br /> A licaiion Preapplication <br /> [fConstruction El Construction 4. DATE RECEIVED BY FEDERAL AGENCY Federal Identifier <br /> 0 Non - Construction ❑ Non - Construction <br /> 5. APPLICANT INFORMATION <br /> Legal Name: Organizational Unit: <br /> City of Eugene Public Works Department <br /> Address (give city, county, State, and zip code): Name and telephone number of person to be contacted on matters involvinc <br /> Eugene, Lane County, OR, 97402 this application (give area code) <br /> Trevor Taylor, (541) 682 -4888 <br /> 6. EMPLOYER IDENTIFICATION NUMBER (EIN): 7. TYPE OF APPLICANT: (enter appropriate letter box) <br /> 191131 61010(211(6 R( Ie <br /> A. State H. Independent School Dist. <br /> 8. TYPE OF APPLICATION: B. County I. State Controlled Institution of Higher Learning <br /> C. Municipal J. Private University <br /> 0 New MI Continuation ['Revision <br /> "Dr`l ownship - K°`lndtarrThbe <br /> If Revision, enter appropriate letter(s) in box(es) I I — E. Interstate L. individual <br /> F. Intermunicipal M. Profit Organization <br /> A. Increase Award B. Decrease Award C. Increase Duration G. Special District N. Other (Specify) <br /> D. Decrease Duration Other(speclfy): <br /> 9. NAME OF FEDERAL AGENCY: <br /> U.S. Bureau of Land Management <br /> 10. CATALOG OF FEDERAL DOMESTIC ASSISTANCE NUMBER: 11. DESCRIPTIVE TITLE OF APPLICANT'S PROJECT: <br /> Wildlife Management 1 (5 — D [A IK Assistance Agreement <br /> TITLE: <br /> 12. AREAS AFFECTED BY PROJECT (Cities, Counties, States, etc.): Task Order <br /> Eugene, Lane County, Oregon <br /> 13. PROPOSED PROJECT 14. CONGRESSIONAL DISTRICTS OF: <br /> Start Date Ending Date a. Applicant b. Project <br /> 5/1/2007 11/30/2007 Fourth Fourth <br /> 15. ESTIMATED FUNDING: 16. IS APPLICATION SUBJECT TO REVIEW BY STATE EXECUTIVE <br /> ORDER 12372 PROCESS? <br /> a. Federal $ d6 <br /> 144'722 a. YES. THIS PREAPPLICATION /APPLICATION WAS MADE <br /> b. Applicant $ 00 AVAILABLE TO THE STATE EXECUTIVE ORDER 12372 <br /> PROCESS FOR REVIEW ON: <br /> c. State $ o0 <br /> DATE <br /> d. Local $ 00 <br /> b. No. 5 PROGRAM IS NOT COVERED BY E. O. 12372 <br /> e. Other $ °D 0 O PROGRAM HAS NOT BEEN SELECTED BY STATE <br /> FOR REVIEW <br /> f. Program Income $ 00 <br /> 17. IS THE APPLICANT DELINQUENT ON ANY FEDERAL DEBT? <br /> g. TOTAL $ w <br /> 144,722 ❑ Yes if "Yes," attach an explanation. GI No <br /> 18. TO THE BEST OF MY KNOWLEDGE AND BELIEF, ALL DATA IN THIS APPLICATION /PREAPPLICATION ARE TRUE AND CORRECT, THE <br /> DOCUMENT HAS BEEN DULY AUTHORIZED BY THE GOVERNING BODY OF THE APPLICANT AND THE APPLICANT WILL COMPLY WITH THE <br /> g._ AT ASSURANCES IF THE ASSISTANCE IS AWARDED. <br /> pe Name of Authoriz:d Representative b. Title c. Telephone Number <br /> / nnis M. Ta o City Manager <br /> 741) 682 -5336 <br /> , fl e of thoriz - epr ; e. Date Sign UM - <br /> U l , Previous Editi n Usable Stindard Form 424 (Rev. 7 -97) <br /> Authorized f Local Reproducti• <br /> tNl /f�l� Prescribed by OMB Circular A-102 <br />