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,� �� Engineering <br /> PROJECT AUTHORIZATION FORM , t. � Public Works <br /> City of Eugene <br /> 244 E. Broadway <br /> #� Eugene, OR 97401 <br /> } ° (541) 682 -5560 <br /> Service ID: / SID PB GL / JC V JE - <br /> Project title: t <br /> (location and work description) 5 , — <br /> Project manager / contact / private engineer. e: , i �. .: �._' , 1 - A <br /> PROJECT SCOPE. 14+`; `i .ot ;. 4 ) t P w ; .,, CO '. I i I 4 , \t' n.l, f �. 17; 3T <br /> ,,Paving:' i. . , `M t�, . � � ‹ '_) L 1 " ' i N t ` to Bike lanes / paths: <br /> ( ' ) (width) <br /> Concrete walks: Setback / Curbside <br /> (length) (width) <br /> Sanitary sewer Storm sewer Landscaping <br /> Signal Street lights ROW required <br /> New building construction Planning, other Remodel <br /> FUNDING SOURCES: ' k. L a 3 QM f . =�+ 6 ''i `r ; % , <br /> , t <br /> City a'` Assessments Other department <br /> Account code <br /> Fed / State / County / FAA ( %, fixed) <br /> COMMENTS / SPECIAL PROJECT INFO. / INTERDEPARTMENTAL WORK DESCRIPTION: <br /> L <br /> . : t i a)," I C &V } - `., _i " 1 • .� 4 i ( ' t'\ 5'» °.3 S 4 .�G,. 1,-. ti4 i,,,_ . .., Y J "•a , f..4 J } 7 j . ''y, <br /> • <br /> a.. , I ► E' ''� r ., E r 1 id ' ate. , :, . v V 4.i. 4.i. i - 1 `_f - _� ` .' <br /> a <br /> jj � <br /> 4 <br /> _ _. L �: ; �a yr ' :.,t i'`" ',.. p TIN <br /> APPROVED: ., t <br /> Project Manager Date <br /> Principal Engineer Date <br /> Facilities Manager Date <br /> City Engineer Date <br /> FOR USE BY ADMINISTRATION ONLY <br /> f l L i Capital Project No. "' ,.t ACK 5 ?I q 3 '3;;; /may k' X C 1 4 SI <br /> t <br /> t <br /> GL Title - `"` C. 1)4e 11 . "'� r 1,. i,� .. 4 t` t�.A t i f, . _` : <br /> Assigned by } 116 o f 1,4 6 ° Date A ih i to r AY/ <br /> Accounting by Date <br /> ATTACHMENTS: <br /> 0 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 /> ❑ File Request Form <br /> ENG 415 WHITE / Finance YELLOW / Administration File PINK / Engineering File GOLDENROD / Project Manager JANUARY 2000 <br />