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RflJECT AUTHORIZATION FORM ~~v y Engineering <br /> 7~' Public Works <br /> • <br /> ~ City of Eugene <br /> 244 E. Broadway <br /> d ~ ~ ~ Eugene, OR 97401 <br /> Service ID: ~-3Z,r (541) 682-5560 <br /> SID PB GL JC JE ~ O5 G~ <br /> Project title: /1%D.t/~~~/ ,(~/Fit)/~~ y >~//~.r~~A1~ ~yTy~,4,d.E~ >.P.A/l J'~ .~f' ~ f~dC <br /> (/ratio and work description) <br /> j3c"/nl/sl.~y~'T iNT k-sE~'Tio.~J.S S7~'if'i.dr~, ~~rs'iC./ii?6, ?/1i1~:G~i~' ~l/l~~.J6'. <br /> Project manager /contact /private engineer: .T /r~i? ~/~s1~.9/Y1 <br /> I <br /> PROJECT SCOPE: <br /> I <br /> Paving: (l~.~G'~i~ t~l~F/ZS ~ ('T,/~,~/~ Bike lanes /paths: S`"T <br /> /widlhsJ (width) <br /> ~ Concrete walks: VA,P~~ S Setback /Curbside <br /> //engthl (width) <br /> ~ Wastewater Stormwater Landscaping /yd <br /> Signal Z,Q'~) Street lights /?D ROW required ~?~i4~ <br /> i <br /> ~ New building construction Planning, other -4 Remodel A/~i9 <br /> { ~ ~ <br /> ~ FUNDING SOURCES: <br /> City "--mss-- Assessments Private Other department <br /> t5 ~ `1~~ Account code <br /> ' Fed /State /County /FAA r~,z n / ~s rI Z. <br /> COMMENTS /SPECIAL PROJECT INFO. /INTERDEPARTMENTAL WORK DESC IPTION: <br /> i tt1 ~ J` r"/i'iU <br /> ` ~ APPROVED: j <br /> Project Manager Date S" =3i ~'S <br /> ~ Principal Engine r ~ Date ~ ' ~ ' 0~ <br /> Facilities Manager Date <br /> City Engineer Date G ~ ° ~ <br /> I <br /> FOR USE BY ADMINISTRATION ONLY <br /> i <br /> j Capital Project No. ~ S 5 ~ ~ ACK ~1 ~ q ~ 3 t ~ X X )l X~j"~ j(~S a <br /> GL Title art ' W <br /> Assigne by Date <br /> Accounting by Date <br /> i <br /> ~ ATTACHMENTS: <br /> i <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 C~Map//,~A <br /> <br /> 'i ? Request for Scoping Meeting i <br /> ENG 415 WHITE /Finance YELLOW /Administration File PINK /Engineering File GOLDENROD /Project Manager ?UL Y2004 <br /> <br />