ࡱ> rtqg bjbjVV wjr<r< $&&&Pv<&8(8888888$s:%=6868K8OOOR8O8OO240mR27a80826=0=,44&=(40"O#?6868`8= : Request for New or Additional Space ¼ϲʿ ALL SPACE REQUESTS REQUIRE APPROVAL BY THE PROVOST OR VICE CHANCELLOR Space Request # ____________ Assigned by OSM I. CONTACT INFORMATION:Requesting Department:Date:Name:Phone:Email:II. DESCRIPTION OF DEPARTMENT:Is this Request for a new Department or Program? Yes ( No (Briefly describe the function of your department. Number of full-time faculty ______, Number of part-time faculty _____, Number of staff _____, Number of student workers _____Do you anticipate the number of people in your department increasing within the next two years? Yes ( No (If yes, indicate anticipated growth: Number of full-time faculty ______, Number of part-time faculty _____, Number of staff _____, Number of student workers _____ How much space do you currently have? (total assignable square feet) III. REQUEST FOR SPACE: If you need assistance completing this form call FP&C at 786-4900 or by email at ayfpc@uaa.alaska.edu. If you need copies of floor plans, they are available on our website at http://fpgis.uaa.alaska.edu/CampusBuildings.htm.Briefly describe why new/additional space is needed. Address the implications to your program/service if additional space is not approved: New space will be used for: Instruction ( Research/Grant ( Administration ( Storage ( Support ( Other, please specifyWhat attempts have been made to locate space within your current space allocation? Has under utilized space been assessed to solve this need? Have shared space possibilities been explored? Have you identified a suitable location for this new space that may be available?Yes ( No (If yes, describe, identify building/room #s or attach drawing/floor plans/diagrams: Have you contacted current holder of the space? Yes ( No (Do they support the concept? Yes ( No (Date Needed Provide information on any time constraints that may affect the timing of allocation of the space.  REQUEST AUTHORIZATION SIGNATURES (the signatures below indicate agreement that the space request should be investigated. Approval to proceed does not indicate a guarantee of space for the purpose outlined in this request.)Department Chair or Director:Date:Comments:Dean/Assoc or Assoc. VC:Date:Comments:Provost/Vice Chancellor:Date:Comments: Forward this completed form with the proper signatures and supporting documents by inter-campus mail to the Facilities Planning & Construction, Office of Space Management (ULB 110). OFFICE OF SPACE MANAGEMENT ACTIONDate Space Request received: Date Plans received:Date Space Assessment completed:Date additional information requested:Less than $50,000, within existing Dept. space & Dept. Funded forward to Facilities for actionOver $50,000, involving Non-Dept space or Non Funded forward to PBAC-Facilities for recommendation and then to Chancellors Cabinet for approvalDate OSM forwards space assessment, completed form and plans to the PBAC-FC:  PBAC- FACILITIES COMMITTEE ACTIONDate reviewed by Committee:Action recommended by Committee:Date Forwarded to PBAC for Action:     Space Request Form  PAGE \* Arabic \* MERGEFORMAT 1 of  NUMPAGES \* Arabic \* MERGEFORMAT 2 Revised 3-3-2011  $BCD  % & żyyymyeZLZeL jrh7vh5XCJaJh7vh5XCJaJh5XCJaJh7vh?=5CJaJh7vh?=CJaJh7vh CJaJh7vh 5CJaJh7vhSM5CJaJh4h45CJaJhIH5CJaJh,1.5CJaJh 5CJaJh)R 5CJaJh hJCJaJhV/hJ5hV/h,5 h45h hJ5$CDQ|kd$$IflM*c+  t 0c+644 lap yt5X $Ifgd $]a$gdIH$a$gd'gdJ$a$gd $a$gd8  vkd$$Ifl 0*w t0c+644 layt5X $Ifgd  % lc $Ifgd4kdC$$Ifl F *vvw t0c+6    44 layt5X% & qY P"$ $If]^ gd5X & F "$$Ifgd|kd$$Ifl *c+  t 0c+644 lap yt5X       ' S b ߾ԾߥxxmbZbmbmhK\CJaJh7vh:ICJaJh7vhCJaJh7vh5CJaJh7vhSM5CJaJh45CJaJh7vhw5CJaJh7vh&{2CJaJ jrh7vhCJaJh7vhCJaJh7vhSMCJaJh7vh'CJaJh7vh?=CJaJh7vh5XCJaJhh5XCJaJ! 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