Special Project Request

SPECIAL PROJECT REQUEST

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Form 1 Alterations, Modifications, Construction

___________________________________________________________________

Return form to Construction Renovation Manager/MTSU PO Box 32 or fax to 898-2298.

Indicate your division:

	Academic Affairs		Business & Finance		President's Office/Athletics
	Student Affairs		Development & University Relations		Information Technology		Other

Requested By:

Date:

Building:

Telephone:

Room Number:

Department requesting project:

Department Currently Occupying Space:

Account Number:

Projected Budget:

In accordance with university asbestos policy established in 1995, all proposed projects which may disturb possible asbestos containing materials, must be reviewed by MTSU health and safety services. If testing is required, a maximum of $1500.00 will be charged to the above noted account number to cover such cost. I agree to this expenditure and understand that I will be billed regardless of whether test results are positive or negative.

Department Head (signature required)

Date

Description of work requested: (Provide sketches where applicable and requested time frame for proposed work to be completed. Attach additional sheets if necessary)

Department Head (Signature Required):

Please print form and fax to Construction/Renovation at 898-2298 with required signatures. If assistance in completing form is needed, please call 898-8308.