From: Subject: Public Art Placement Request Date: Wed, 2 Dec 2009 22:03:12 -0500 MIME-Version: 1.0 Content-Type: text/html; charset="Windows-1252" Content-Transfer-Encoding: quoted-printable Content-Location: file://C:\Documents and Settings\dboone\Local Settings\Temp\notes93A599\~7869316.html X-MimeOLE: Produced By Microsoft MimeOLE V6.00.2900.5579 Public Art = Placement Request

 

Site=20 Plan Project Number____________

 

Public Art Placement = Request=20 Form

 

Name of=20 Individual or Organization=20 _______________________________________________________=

 

Address=20 _________________________________________________________________________= ____

 

__________________________________________________________________= __________________

 

Contact=20 Person=20 _______________________________________________________________________

 

Phone=20 ______________________   = Fax=20 ______________________   = E-mail=20 ______________________

 

Artist=92s=20 name=20 _________________________________________________________________________=

 

Artist=92s=20 address=20 _______________________________________________________________________

 

Artist=92s=20 phone ____________________ Artist=92s Fax _____________  Artist=92s=20 E-mail_________________

 

Title of=20 the Artwork=20 ____________________________________________________________________=

 

Size and=20 Medium=20 _____________________________________________________________________

 

 

What is the=20 exact address of the site where the artwork would be located?  Submit a map or drawing = with location=20 of site identified.

 

__________________________________________________________________= _________________

 

Is this=20 location (check all that apply)

r  Town of=20 Cary = property

r  Private = property

r  On an = easement

r  On a right of = way

r  Other (please describe):=20 _____________________________________________________________<= /SPAN>

 

 

Proposed=20 installation date=20 ______________________________________________________________=

 

This=20 artwork is:   = r Permanent placement      =20 r Temporary=20 placement

 

If=20 temporarily installed, proposed removal date=20 ______________________________________________

 

 

Attach a photo of the site = (or=20 submit a drawing) identifying the desired location and orientation for = the=20 artwork.

 

 

 

 

 

Describe the artwork = (include size,=20 scale and materials) and attach a photo or sketch of the artwork.  (Attach sheets if=20 necessary.)

 

 

 

 

 

 

 

 

 

 

 

 

Installation Plan (please = check if=20 applicable):

 

r Street closure?  If yes, which streets and = when?=20 ________________________________________

 

__________________________________________________________________= _______________

 

 

r Equipment Rental?  If yes, what kind?=20 ________________________________________________

 

r Need to pour = concrete?  If yes, approximate size or = amount. =20 ______________________________

 

r Digging?  (Before digging, call NC = One-Call at=20 800-632-4949 to have the lines marked)

 

r Other (please describe)=20 ___________________________________________________________

 

__________________________________________________________________= _______________

 

 

 

Describe=20 the process for informing citizens of Cary about the placement of = the artwork=20 prior to and after installation.

 

 

 

 

 

 

Will=20 signage be included to describe the artwork?  Describe size and placement of = signage.  =

 

 

 

 

 

r     =20 Planning:  Check here if application = needs review=20 by Engineering and comments:

 

 

 

 

 

r     =20 Engineering:  Check here if inspections or = permits are=20 required and comments:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

REVIEWED

 

Signed:=20 _________________________________  = Date: _____________________

           &n= bsp;  =20 Public Art Coordinator

 

 

 

 

 

Date of=20 presentation by

Public Art=20 Coordinator to Public Art Advisory Board=20 _________________________________

 

 

Comments by=20 Public Art Advisory Board:

 

 

 

 

 

 

 

 

Date of=20 Public Art Placement Notification mailed to applicant=20 ____________________________

 

 

 

 

Return Completed Public = Art=20 Placement Request Form

and All Documentation to = Denise=20 Dickens, Public Art Coordinator

Town of=20 Cary,=20 P.O. Box=20 8005, Cary, NC  27512-8005

Questions denise.dickens@townofcary.o= rg or=20 919-465-4791 direct