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APPLICATION FOR oMBApproval No. o34s-ooa3 <br /> FEDERAL ASSISTANCE 2. D`~^^A~TE SUBMITTED Applicant Identifier <br /> VG ~ (7~ <br /> 1. TYPE OF SUBMISSION: 3. DATE RECEIVED BY TATE State Application Identifier <br /> A lication Preapplication <br /> Construction ~ Construction 4. DATE RECEIVED BY FEDERAL AGENCY Federal Identifier <br /> ? Non-Construction Non-Construction <br /> 5. APPLICANT INFORMATION <br /> Legal Name: Organizational Unit: ( <br /> City of Eugene l~u. I~G i~.~o? S DG at/'~r1~'~" <br /> Address (give city, county, State, and zip code): Name and telephone number of person to be cunt cted on matters involvin <br /> Eugene, Lane County, OR, 97402 this application (give area code) K„e,(-~- Cot'Gy <br /> 5 H1~ ~ 4'a - S~ <br /> 6. EMPLOYER IDENTIFICATION NUMBER (EIN): 7. TYP OF APPLICANT: (enter appropriate letter in box) <br /> - G <br /> 9 3 6 0 0 2 1 6 0 A. State H. Independent School Dist. <br /> 8. TYPE OF APPLICATION: B. County I. State Controlled Institution of Higher Learning <br /> New ? Continuation ?Revision C. Municipal J. Private University <br /> D. Township K. Indian Tribe <br /> <br /> { If Revision, enter appropriate letter(s) in box(es) ~ ~ E. Interstate L. Individual <br /> j 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 /> - D ~ As6. S+~ ~ ,4~,ree~,w,f: ~'A 1731 M D~ <br /> 12. AREAS AFFECTED i Y PROJECT (Cities, County ,States, e~): ~Gt S ~ o rd~ FD `/l l~5 <br /> 13. PROPOSED P OJECT 14. CONGRESSIONAL. DISTR CTS OF: <br /> Start Date Ending Date a. Applicant b. Project <br /> 9-a3-o f1-3o_05 Faw~~. FoKr-t~ <br /> 15. ESTIMATED FUNDING: 16. IS APPLICATION SUBJECT TO REVIEW BY STATE EXECUTIVE <br /> ORDER 12372 PROCESS? <br /> a. Federal $ o0 <br /> S ~ DD ~ 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. ~ROGRAM 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 $ 00 <br /> 17. IS THE APPLICANT DELINQUENT ON ANY FEDERAL DEBT? <br /> g. TOTAL $ .00 <br /> S ~ ? Yes If "Yes," attach an explanation. p~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 /> ATTACHED ASSURANCES IF THE ASSISTANCE IS AWARDED. <br /> a. Type Name of Authorized Representative b. Tie c. Telephone Number <br /> ~.r cor ttib)~~ Wv~KS 5Yr- 68~- baba <br /> f>~ d. Signature of Authorized R v e. Date Signed <br /> s~ 1° <br /> Previous Edition Usable Standard Form 424 (Rev. 7-97) <br /> Authorized for Local Reproduction Prescribed by OMB Circular A-102 <br /> • <br /> <br />