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r. <br /> Public Works <br /> Maintenance & <br /> PROJECT AUTHORIZATION FORM EliGENE Parks and Open Space <br /> City of Eugene <br /> 1820 Roosevelt Boulevard <br /> Eugene, Oregon 97402 <br /> (541) 682 -4800 <br /> °C) (541) 682 -4882 FAX <br /> Service ID: I 0 SID PB GL JC JE www.eugene - or.gov /parks <br /> Project Title: (. )(2-+I 0 A Pl. 72ht M 2Z -0,1j 1....5 <br /> (location and work description) <br /> Proj Manage Contact/Private Engineer: TY?_ iab'1 .\ a r +(_ ;lit ;5 <br /> PROJECT SCOPE: <br /> Paving: Bike lanes /paths: <br /> (widths) (width) <br /> Concrete walks: Setback/Curbside <br /> (length) (width) <br /> Wastewater Stormwater Landscaping <br /> Signal Street lights ROW required <br /> New building construction Planning, Other tti't C' "t'S Pl P)t Remodel <br /> FUNDING SOURCES: <br /> City Assessments Private Other Department <br /> Account Code 5 3 - q'-33s <br /> Fed , State / Count / FAA t () 0 ( %, fixed) <br /> COMMENTS / SPECIAL PROJECT INFO. / INTERDEPARTMENTAL WORK DESCRIPTION: l <br /> ~Xp>?�5e,..5 'a S 5 c I ;t-ct v,,' t& c , ve It /0 rs-tlt c ��1 dwl� <br /> 1)-1 .(5 As 4-- -L-kk is L, NI , — 5 7 se'r 1 e---t. '', s i■ 6 el <br /> APPROVED: <br /> Project Manager: ,�, 6+ u.. Date: • / R 'di-- <br /> Section Manager: / r C721 Date: + �* <br /> ate: � � r� l - (i' <br /> Financial Analyst: '' '`..4:F, i Date: S - Zi —6) -7- <br /> / Z` 7 <br /> Division Manager: i i fi_ // . Date: <br /> 0Z'ior7 - 1 - so PLk FOR USE BY ADMINISTRATION ONLY <br /> Capital Project No. ACK <br /> GL Title <br /> Assigned by: Date: <br /> Accounting by: Date: <br /> ATTACHMENTS: <br /> ❑ Budget Estimate ❑ Developer Agreement ❑ Engineer's Report on Improvement Petition <br /> ❑ SDC Budget Worksheet ❑ Engineering Agreement ❑ Engineering Service Work Request <br /> ❑ City Engineer's Initiating Order ❑ Public Improvement Permit Application ❑ Map <br /> ❑ Request for Scoping Meeting <br /> PWM /POS 100 WHITE /Finance YELLOW /PW Administration File PINK/Division File GOLDENROD /Project Manager July 2006 <br />