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4. List the utilities that are needed (electric, water, gas, etc.) What will happen to the
installation if the electricity, water, gas, etc. is shut off?
5. How will the costs of the project be funded?
6. What are plans or requirements for maintaining the project?
7. For art installations, if the installation falls down or apart, how far will it travel? Where
will it land?
8. For temporary installations, what is the removal process and when will it be removed?
Statement of Responsibility
• I certify that the responses on this form are accurate to the best of my knowledge and that I am authorized
to act on behalf of the requesting entity.
• I acknowledge that any costs that have not been approved through the college’s regular budgeting process
will be the responsibility of the applicant(s).
• I understand that variations from the elements described in this application made after the approval may
result in the withdrawal of the approval and/or removal of any displays at the expense of the applicant(s).
• I understand that this application will not add the event to the campus calendar or replace the need for work
orders.
Authorized Signature:______________________________ Date:_________________
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To be completed by Policy and Planning Council:
Date Reviewed: ___________________
Outcome:
____ Approved as submitted.
____ Additional information required before approval can be granted. (See attached)
____ Declined. (See attached)
Authorized signature: ____________________________ Date:__________________
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