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ppP~ (CATION FOR oMB Approval No. t~34s-a <br /> FEDERAL ASSISTANCE 2. DATE SUBMITTED Applicant Identifier . • <br /> 1, n(PE OF SUBMISSION: 3. DATE RECEIVED BY STATE State Application Identifier - <br /> ication Preapplication <br /> ~ConstrucUon ~ Construction 4. DATE RECEIVED BY FEDERAL AGENCY Federal Identifier <br /> Non-Construction Non-Construction- <br /> 5,APPLICANT INFORMATION <br /> Legal Name: O a i Zion Uni <br /> City of Eugene ~u~i~i c ~lor~CS Eng•i neeri ng <br /> <br /> i <br /> address (give city, county, State, and zip code): Name and telephone number of per$on to be contacted on matters invoh <br /> ~ 858 Pearl Street this application(give area code) <br /> Eugene OR 97401 Therese Walch (541) 682{839 <br /> 6. EMPLOYER IDENTIFICATION NUMBER (EIN): 7. TYPE OF APPLICANT: (enter appropriate tetterin box) <br /> 9 3-~0 0 21 60? <br /> A. State H. Independent School Dist <br /> 8. TYPE OF APPLICATION: B. County 1. State Controlled Institution of Higher Learning <br /> New ? Conttnuation ? Revision C. Municipal J. Private University <br /> D. Township K. Indian Tribe <br /> ff Revision, enter appropriate letter(s) in box(es) ~ a E. Interstate L. Individual <br /> - F. Intermunidpal M. Profit Organization <br /> A. Irxxease Award B. Decrease Award C. increase Duration G. Special DisMct N. Other (Specify) <br /> D. Decease Duration . Other(speaty): <br /> 9. NAME OF FEDERAL AGENCY: <br /> United States Environmental Protection <br /> A enc. - ~ . <br /> 10. CATALOG OF FEDERAL DOMESTIC ASSISTANCE NUMBER: 11. DESCRIPTIVE TITLE OF APPLICANT'S PROJECT: <br /> Wetland Mitigation Bank Long Term <br /> __________TITLE;_______ ~ . Maintenance .Cost Assessment <br /> 12 AREAS AFFECTED BY PROJECT (Cities, Counties, States, eta): . <br /> ...Lane County . <br /> 13. PROPOSED PROJECT 14. CONGRESSIONAL DISTRICTS OF: <br /> Start Date Endln~'"Date.. a. Applicant b. Project <br /> 5 1 00 2/28/01 Gity of Eugene - 4th 4th . <br /> 15. ESTIMATED FUNDING: - 16. IS APPLICATION SUBJECT TO REVIEW BY STATE EXECUTIVE <br /> - ~ ORDER 12372 PROCESS? <br /> a Federal $6 , 500 ~ <br /> - a. YES. THIS PREAPPLICATIOWAPPUCATION WAS MAD[: <br /> b. Applicant - - .00 _ AVAILABLE-TO THE-STATE-t~(ECUTIVE ORDER 1-2372 <br /> a State $ .00 <br /> - DATE <br /> d. Local $ ~ .00 - <br /> • b. No. ~ PROGRAM IS NOT COVERED BY E. 0.12372 <br /> e. Other $ ~ .00 ? OR PROGRAM HAS NOT BEEN SELECTED BY STATE <br /> FOR REVIEW <br /> E Program income $ .00 <br /> 17. IS THE APPLICANT DEUNOUENT ON ANY FEDERAL DEBT? <br /> g. TOTAL $ .00 <br /> $ ~ $QQ ? Yes If "Yes," attach an explanation. No <br /> 18. TO THE BEST OF MY KNOWLEDGE AND BELIEF, ALL DATA IN THIS APPLICATION/PREAPPUCATION 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. Title c. j~gphQnelSt~ba~ 41 <br /> Christine Andersen Public Works Director ` 411 bt5 b <br /> Sig to ' of Authorized epresentative ~ e. Date ig <br /> previous Edition Usable Stan rd Form 424 (Rev. 7-97) <br /> Authorized for Local Reproduction Prescribed by OMB Circular A-102 <br /> ~i Fl • <br /> <br />