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APPLICATION FOR OMB Approval No. 0348-0043 <br /> FEDERAL ASSISTANCE 2. DATE SUBMITTED Applicant Identifier <br /> ~u us~f 1 ,,2v~5 <br /> I 1. TYPE OF SUBMISSION: 3. DATE ECEIVED BY STATE State Application Identifier <br /> A lication Preapplication <br /> Construction ~ Construction 4. DATE RECEIVED BY FEDERAL AGENCY Federal Identifier <br /> ? Non-Construction Non-Construction <br /> j 5. APPLICANT INFORMATION <br /> Legal Name: Organizational Unit: <br /> City of Eugene i;~% t.~~l'~-~ ~ ~,t~~t <br /> I <br /> Address (give city, county, State, and zip code): .Name and telephone number of person to be contacte on matters involvin <br /> i this application (give area code) ~O <br /> Eugene, Lane County, OR, 97402 <br /> 6. EMPLOYER IDENTIFICATION NUMBER (E1N): 7. TYPE OF APPLICANT: (enter appropriate letter in box) <br /> 9 3 - ©0 0 2 ~ 6 0? A. State H. Independent School Dist. <br /> <br /> j 8. TYPE OF APPLICATION: B. County I. State Controlled Institution of Higher Learning <br /> Q? New ? Continuation ?Revision C. Municipal J. Private University <br /> D. Township K. Indian Tribe <br /> If Revision, enter appropriate letter(s) in box(es) ~ ~ 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(specify): <br /> 9. NAME OF FEDERAL AGENCY: <br /> 10. CATALOG OF FEDERAL DOMESTIC ASSISTANCE NUMBER: 11. DESCRIPTIVE TITLE OF APPLICANT'S PROJECT: <br /> ,~,f t 5 - ~ ~ ~ /}SSfca, ff~r~L~~=: /~Af~a~jla'~i~t~ <br /> TITLE: V'~ D ~ i .lZ. L~/1~ lw~+w~' yy ~1 _ <br /> 12. AREAS AFFECTED BY PROJECT (Cities, Counties, States, etc.): 1. = T/ tg~(~ j ~ I d <br /> 13. PROPOSED PROJECT 14. CONGRESSIONAL DISTRICTS OF: <br /> Start Date Ending Date a. Applicant b. Project <br /> 15. ESTIMATED FUNDING: 16. IS APPLICATION SUBJECT TO REVIEW BY STATE EXECUTIVE <br /> ORDER 12372 PROCESS? <br /> a. Federal $ .00 <br /> - / ~ t~ 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 $ •00 <br /> DATE <br /> d. Local $ •°D <br /> b. No. ~OGRAM IS NOT COVERED BY E. O. 12372 <br /> e. Other $ .00 ? OR PROGRAM HAS NOT BEEN SELECTED BY STATE <br /> FOR REVIEW <br /> f. Program Income $ o0 <br /> 17. IS THE APPLICANT DELINQUENT ON ANY FEDERAL DEBT? <br /> g. TOTAL $ 00 <br /> ~~r ? Yes If "Yes," attach an explanation. [j~o <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 /> J ATTACHED ASSURANCES IF THE ASSISTANCE IS AWARDED. <br /> ~ a. Type Name of Authorized Representative b. Titl c. Telephone Number <br /> d. Signature of Authorized Representative e. Date Signed ~ l,6 '7S <br /> Previous Edition Usable Standard Form 424 (Rev. 7-97) <br /> Authorized for Local Reproduction Prescribed by OMB Circular A-102 <br /> <br />