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<br />ORGANIZATION: if.8 <br />ADDRESS:3~~s <br />CrfYtSTATElZlp.Sa~1 .m~YC..aJ -zif;(4S 1fR/~ <br />TELEPHONE: (Day) ZS....9~.A.J. tJ .J (EveI1thg).. g2t-: OY6/ {Fax) <br />CONTACT PERSON1?~LJ1'l Wi:~'(,fJ$K.{)rI~MAIL ADPRESS:~kV~ C 'r6.~eC()VJ?'tnef <br />Please li~t (in Qrder of preference) fuaproposedloc~tjofl(SJ, lf1ctuding name offaciliijtand street <br />address; <br /> <br /> <br />APPLlCA TION <br />OF PERMANENT <br />MONUMENTS ANDS <br /> <br /> <br />OR THE PLACE <br />TEMPORARY <br />RES ON CITY <br />I'J No. 2005-43R <br /> <br /> <br />1, c!)R <br />Me <br />2. tV ~.e;1 ) <br /> <br />Is..tM PU~!iC artwoTkintended to .~a~f temporary? <br />Iftel11po ra ry, please define the exact ti meframe; <br /> <br /> <br /> <br />t'y~ S':1!eJ.vA:tKJ <br /> <br />(e i rcleone) <br /> <br />THE FOLlO~MNG ATTfl.CHMENTS ARE REQUIRED: <br /> <br />. A.visual depiction or modelofthe .artworK monqtnenior structure <br />. A .$tatem~l"ttJ'loting the appropriatene$S of the pfoposedartwofk, monument or structl.l:retobeplaced <br />on. dty property. <br />. An estimatEloftneco5t required to place 'he ariwor'f., monument or;$tn.duteoncJtyproperty. <br />. A deacrrpijonof the artwork, monl.lment,oT$truct:ure and rts estimatedsrze and value. <br />. A descripti:on and list of materials to be used in placing the art, mQPul"l'IentoJ'strlJ'cture on city <br />propert'.v, <br />. A statement noting the role 01 thecityjn ttl~Qn-g{)ing maintenance (repairs, utili~es,etcl.and <br />operation ofthearM'ork, monumentorstmcture <br />. Anycondlti()1ls. associated with tllepf<?posedplacement. <br />. For any appIlcatitmfor placing a st(uqtureonCity Property,anarrEltiveth$t atldresses operation and <br />use l$$.ues. <br /> <br /> <br />II\\le underStaOQ tha~ 1l1f~e must particip in a review process that may inclu defue San Marco$ Arts <br />Qommissio n, Crty Oouncil,cityd epartm .,andot~erapp.ropna~boarcts.Ct:lmmjssjonsMdlor <br />nelghporhood as!iiO cialions, as n~(jed, in accordance WjththeCity~sArt in Pubtlc fllt;l(:es PoH~- <br />I havereoeived ;3CQPY of the Alii P Places Policy and Procedural Guidelines. <br /> <br />~ !~5-o/ <br />Date <br />