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1 <br /> PRO~~CCT AUTHORIZATION FORM Engineering <br /> Public Works <br /> City of Eugene <br /> ~ ~ 244 E. Broadway <br /> r%r i'-" Eugene, OR 97401 <br /> ; ,k t. (541) 682-5560 <br /> eIQ:~' SID PB GL~JC~ JE~~ <br /> i ~ /roject title: ~~-~..iC.~C~GV~~.. ~ t'">~.Q~~ (.~5 ~ 1 <br /> ~ ~~Cir't' SI~-t <br /> i (/ocalion and work desc~iplionJ <br /> Project manager /contact /private engineer: <br /> PROJECT SCpPE: <br /> Paving: Bike lanes /paths: <br /> (widlhsJ (widlhf <br /> Concrete-walks: Setback /Curbside <br /> (/engthJ (wrdlhJ <br /> ~ Wastewater Stormwater Landscaping <br /> ~ Signal ? ~ Street lights ROW required <br /> New building construction Planning, other Remodel <br /> FUNDING SOURCES: <br /> I <br /> City Assessments Private ~ Other department <br /> Account code <br /> r <br /> g feed /State /County /FAA fixed) <br /> ~~iCOMMENTS / SPACIAL PROJECT INFO. /INTERDEPARTMENTAL WORK DESCRIPTION: <br /> J; . <br /> x <br /> APPROVED: <br /> Project Manager Date 7 <br /> i Principal Engineer ~ ~ Date <br /> Facilities Manage Date <br /> ! City Engineer~'`~ ' <br /> ~ ~ Date f/' ~ c% Uo <br /> 4 <br /> T <br /> FOR USE BY ADMINIS2TRAC~TION ONLY / T <br /> Capital Project No. `t~.L~/'~ ACK ~ ~ J ~ ~ t ~ ' ~p XX ~X " (~,J <br /> ~ GL Title ~ ~ ' ~ ~ <br /> ` i <br /> ~ Assigned by Date _ <br /> I <br /> " Accounting by Date <br /> ~ ATTACHMENTS: <br /> ~ ? Budget Estimate ? Developer Agreement ? Engineer's Report On Improvement Petition <br /> ? SDC Budget Worksheet ~I Engineering Agreement ? Engineering Service Work Request <br /> City Engineer's Initiating Order I`~1"I Public Improveme t Permit Application ? Map <br /> ` ? Request for Scoping Meeting ~ r~/,~T-~,/~,, <br /> ENG 415 WHITE /Finance YELLOW /Administration File PIN4 K / Engineerin File GOLDENROD / Pro'ect Mana er ?ULY2004 <br /> 9 1 9 <br /> <br /> I <br /> <br /> ~ _ _ - . - i <br /> <br />