(EXAMPLE ONLY)

                                          Project Initiation Request

Complete Sections A and B and forward to Facilities Design & Construction, 165 Wilber Hall
 
 

A. Requestor Information Date: _____________________________

Requestor’s Name: _______________________ Phone # ___________________________
 
 

Department: ____________________________ Campus Address: ____________________
 
 

Project Location: _______________________________________________________________
 
 

Current Space Use: ___________________________________________________________
 
 

Proposed Space Use: ___________________________________________________________
 
 

Project Description: (attach sketches if pertinent)
 

B. Department Dean or VP Concept Approval:
 
 

Concept Approval Signature: _______________________________ Date: ____________
 
 

Intended Funding Source:  Department Operating Funds

                     Capital Funding (requires PC approval)  Other: _________________________

C. Space below for use by Facilities Management
 
 

Log # ___________________ Initial: ___________ Date: ____________
 
 

Forwarded to:  FO&E  FD&C Date: ____________