2. Public Artwork Application Form
   TOWN OF CRESTON
4. HOW TO APPLY FOR INSTALLATION OF PUBIC ARTWORK
   The Town of Creston has an extensive policy framework to allow Council to make an informed decision related to the installation of public artwork, including murals. Read the Town of Creston policy and guidelines carefully. Applications that do not include all the required materials (review checklist) will not be processed for Council’s consideration. Allow for up to four to six weeks for processing applications and receiving Council approval.
6. APPLICANT CONTACT DETAILS
8. Date of Application (YYYY-MM-DD)
9. Indicate whether installation is on public or private property

   1. Public Property

   1. Private Property
11. Lead Organization (if applicable)
13. Contact Name / Project Coordinator (First and Last Name)*
15. Email Address (considered the most efficient and prompt way we can communicate with you)
17. Mailing Address*
    Note: If only a mailing address is provided, our response times may be extended
18. Phone Number*
    Note: We only call if we require clarification
20. CHECK ALL ITEMS SUBMITTED WITH APPLICATION

    1. Site location (photograph)
    2. Preliminary sketch or mock up of art
    3. Objectives and scope of project
    4. Permits from Municipality (if applicable)
    5. Budget & funding sources from project
    6. Permission from property owner
    7. Proof of funding

    1. Time schedule (installation & clean up)
    2. Mural maintenance plan
    3. Proof of liability insurance
    4. Signed contract with artist
    5. Outline of method / product used
    6. Outline public consultation (if req.)
    7. Plan for maintenance
22. Note: Submission of an application does not constitute approval. The Town of Creston Council will only review completed application. Incomplete applications may add additional time for approval. If permits are required (sign permit for logos and advertising, or building permits for installation of materials), then these permits shall be obtained PRIOR to submitting this application.
24. BUDGET / FUNDING SOURCE
    Provide a budget of project, including secured funding sources. Proof of funding source is required. A detailed budget may be attached to the application as a separate document.
26. EXPENSES
    Artist Fees
27. Estimated Cost
29. Material Costs (paint, brushes, rollers, installation hardware, etc.)
30. Estimated Cost
32. Scaffolding (required if artist has to work above 3m)
33. Estimated Cost
35. Traffic Management Plan (If applicable)
36. Estimated Cost
38. Health and Safety (ladder, traffic cones, telescopic arms, high visibility vests, face masks, drop sheets, etc. )
39. Estimated Cost
41. Miscellaneous Fees
42. Estimated Cost
44. Total Expenses
46. Funding Sources
48. Private Donations
49. Estimated Funding
51. Grants (provide sources)
52. Estimated Funding
54. Contributions in lieu of cash
55. Estimated Funding
57. Total Funding Sources
59. Note: Proof of all funding sources are required, including confirmation that funding is allocated for such purposes. For example, a grant approval must show that the grant is to be spend on public art on either public or private land.
61. List of budget enclosures
    Include copies of any documentation supporting budget and funding.
63. Documentation supporting budget and funding
65. PROPOSED SITE OF PUBLIC ARTWORK
67. Civic Address*
69. Property Owner Contact Information (first and last name)*
    Complete if only privately owned
71. Email Address
    Considered the most efficient
73. Mailing Address*
    Note: If only a mailing address is provided, timelines may be extended
74. Phone Number*
    Note: We only call if we require clarification
76. Note: A signed agreement with a private owner is required to be submitted with the application.
77. Signed Agreement
79. Project Information
    Provide a brief description of the project (Max 500 words)
81. Project Information
    Outline the objectives and goals of the project (Max 500 words)
83. Project Information
    Outline the project schedule - set-up, installation and clean-up (Max 250 words)
85. Project Information
    Outline maintenance and roles / responsibilities (Max 300 words)
87. Project Information
    Describe inspection plan for maintenance needs and timing for required repairs (Max 300 words)
89. Project Information
    Outline method and products used for public art installation (Max 300 words)
91. Project Information
    Outline community consultation (required if within 60m of residential zoning) (Max 300 words)
93. TERMS AND CONDITIONS OF PUBLIC ARTWORK PROGRAM
    Print Name
95. (the "applicant") represents and warrants to the Town of Creston (the “Town”) that:
97. (a) the Applicant is the legal beneficial owner at:
99. Address
101. (the “Property”) OR has obtained the consent of the legal and beneficial owner of the Property to participate in the Public Artwork Program by obtaining and submitting with this document a signed release and consent of the property owner in the form attached as Appendix 2;
103. (b) the Applicant has full power and authority to enter into the terms and condition attached hereto as Appendix 1; and
105. (c) no other person or entity is required to consent to the completion of the mural described in the Applicant’s Preliminary Application for the Public Artwork Program (the “Project”), including, without limitation, any tenant, occupant, or operator of the Property.
107. The Applicant agrees that by signing and submitting this document, they are bound by the terms and conditions attached hereto as Appendix 1. The Applicant will disclose to the Town any additional funding or support they have received or requested for the Project from any public entities, such as the Regional District, Columbia Basin Trust, etc. The Applicant will ensure that the Project complies, and that all persons involved in the Project will comply at all times, with all applicable health and safety requirements contained in applicable statutes, regulations, codes and by-laws, and, to the Town’s satisfaction, with Town policies for workplace safety, and, without limitation to the foregoing, the Applicant shall ensure that all persons involved in the implementation of the Project are protected under the Workers Compensation Act.
109. Applicant / Authorized Signatory of Applicant
     Print Name
110. Date
     Date
Leave This Blank:


112. 1. Receive an email copy of this form.
113. Email address

     This field is not part of the form submission.

114. Submit

* indicates a required field