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` <br /> I PROJECT AUTHORIZATION FORM Engineering <br /> ~ ~ Public Works <br /> ~ 12, jaity of Eugene <br /> ~ 244 E. Broadway <br /> Eugene, OR 97401 <br /> / ~ (541) 682-5560 <br /> Service ID: ~-3~3 SID PB GL J~ JC f~ JE <br /> Project title: S~pr~ i:..lGte~ 5., ~ ~ ~ Q,~,J rz_, r ~I} ~ ~a,~r n i r <br /> i (/ocabon and work descnplicnJ <br /> Project manager /contact /private engineer: a I` ~ Q ~ <br /> i <br /> i <br /> PROJECT SCOPE: <br /> Paving: Bike lanes /paths: <br /> (widths) <br /> (widlhJ <br /> j Concrete walks: Setback /Curbside <br /> ' (/engthl (widlhJ <br /> Wastewater Stormwater Landscaping <br /> I <br /> Signal Street lights ROW required <br /> I <br /> New building construction Planning, other Remodel <br /> FUNDING SOURCES: f ~ X a~~ ~3 ~ Q,i3o( ~'/79~ 4~'~"pdj~+ <br /> City 5~ U j-; l ~ ~ ~ F~ Assessments Private Other department <br /> S3 ~ - 5~ ~e~U~o Account code <br /> ~ Fed /State /County /FAA fixed) <br /> COMME TS /SPECIAL ROJECT INFO. / INTERDEP(~RTMENTAL WORK DESCRIPTION: <br /> o~ ~ure(;~~ o~ ~'wE "iZ ~ oi= r r~- w~ ~ ~r.ex~- ~.,~.iv~~ <br /> P J 1M C Y1 S C S L <br /> c.. G. U. N^-.. ~ C -F S 4 ~ A I'G - ~ 1 <br /> i <br /> ~ :~~i ~ f <br /> u~~ <br /> ,F~ i~, ~ t r f <br /> i -~€s-~' APPROVED: <br /> I Project Manager Date 11 ~3 ~ <br /> ~ ' Principal Engineer Date~D 4- <br /> Facilities Manage Date <br /> City Engine / Date ~ ` ~ `1'- <br /> - FOR USE BY ADMINISTRATION ONLY <br /> i <br /> Capital Project No. `7$SO3 ~ ACK 3' ~ `7~3OZ ~'XxkX ~,6~'SQ~ Q <br /> I , <br /> f ' GL Title ATM Su.~~eM Rev~e~ t~t'P <br /> <br /> i Assigned by Date ~ <br /> y <br /> <br /> I <br /> <br /> j Accounting by Date <br /> <br /> ~ I <br /> ATTACHMENTS: i <br /> Budget Estimate ? Developer Agreement ? Engineer's Report On Improvement Petition <br /> ? SDC Budget Worksheet ? Engineering Agreement ? Engineering Service Work Request i <br /> ? City Engineer's Initiating Order ? Public Improvement Permit Application ? Map j <br /> ? Request for Scoping Meeting <br /> <br /> f I <br /> ENG 415 WHITE /Finance YELLOW /Administration File PINK /Engineering File GOLDENROD /Project Manager ?UL Y2004 <br /> - - - - <br /> <br />