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~ t <br /> j j <br /> ,,...'~~OJ~CT AUTHORIZATION FORM I~`~~ Engineering <br /> ~ Public Works <br /> . City of Eugene <br /> 244 E. Broadway <br /> tfi Eugene, OR 97401 <br /> ? ? ~ (541)682-5560 <br /> V <br /> GL JC JE <br /> Service ID:~/ L~~ SID PB tt'' <br /> 'f(~t <br /> 1 <br /> Project title: ~ ~ <br /> //oca o n work descri ion) j <br /> Project manager /contact !private engineer: <br /> PROJECT SLOPE: ~ i <br /> o <br /> Paving: ~Z ~ ~ ~ , ` V ~ r I ~S Bike lanes /paths: <br /> (wid/hsJ (width) <br /> Concrete walks: ~ Setback /Curbside 1 <br /> (/engthJ ~e (widlhl <br /> Wastewater St~~mwater Landscaping ! <br /> I <br /> <br /> li Signal St eet lights ROW required i <br /> New building construction Planning, other Remodel <br /> FUNDING SOURCES: ~ j lJ K ~orvl 3 j <br /> City Assessments Private Other department <br /> ~ Account code ~ <br /> 'F ~ Fed /State /County /FAA fixed) <br /> COMMENTS /SPECIAL PROJECT INFO. /INTERDEPARTMENTAL WORK DESCRIPTION: <br /> ~ ~ / <br /> I <br /> i <br /> i <br /> i <br /> i <br /> APPROVED: (~~/Z ~P~~~,• <br /> Project Manager Date i; <br /> i Principal Engineer Date ~ ~ 2 ~ - d <br /> Facilities Manager Date <br /> City Engineer Date ° Z ~ ` i <br /> 1 I <br /> FOR USE BY ADMINISTRATION ONLY i <br /> Q ~3 ~i33z.. t~~xx~c Q(~SSZy <br /> Capital Project No. t ~ SS Z~ ACK <br /> i GL Title j <br /> j Assigned b Date " 3~ <br /> Accounting by Date <br /> i ~ <br /> TTACHMENTS: <br /> Budget Estimate ? Developer Agreement ? Engineer's Report On Improvement Petition <br /> ? DC Budget Worksheet ? Engineering Agreement ? Engineering Service Work Request y <br /> ? City Engineer's Initiating Order ? Public Improvement Permit Application Map j <br /> ? Request for Scoping Meeting ~ <br /> ENG 415 WHITE /Finance YELLOW /Administration File PINK /Engineering File GOLDENROD /Project Manager ?UL Y2004 j <br /> <br />