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i <br /> ' ~ t~RO,!~ECT' AUTHORIZATION FORM ~ ` Engineering <br /> ' Public Works <br /> City of Eugene <br /> 244 E. Broadway <br /> (~+J ~ Eugene, OR 97401 <br /> L/ ? a (541) 682-5560 <br /> Service ID: ~ / SID PB GL JC JE <br /> Project title: /3.4it/K k'EPA/1? - f~IMA,~=C~iy ~,~~~jT` ~"(~X /-„J~j~ ~ ~1q~ <br /> (location and work description/ <br /> Project manager /contact /private engineer: _ j/~(f~j ~iV <br /> ~ <br /> PROJECT SCOPE: <br /> Paving: Bike lanes /paths: <br /> (widths/ <br /> (width) <br /> Concrete walks: Setback /Curbside <br /> (/engthl (width) <br /> Wastewater Stormwater ~IIL~'.~AL L _ Landscaping _ <br /> Signal Street lights _ ROW required <br /> New building construction- Planning, other Remodel <br /> FUNDING SOURCES: X 5 ~i j x'133.? (r71~35 s3oa~ l~ r,- <br /> City _ Assessments Private _ Other department <br /> Account code <br /> i Fed /State /County /FAA _ _ fixed) <br /> ~ COMMENTS /SPECIAL PROJECT INFO. /INTERDEPARTMENTAL WORK DESCRIPTION: <br /> _ /2E~-~i~~_,~,>~'X ,~'i,~'E G~rrTF.~ ~ ~~-~4~~~~~ ~~~1 G ~ /T wlT f~ <br /> ~ ~ ~ "i E _ ~i~. <br /> . ~ <br /> <br /> i, <br /> N Y. <br /> APPROVED: <br /> Project Manager. Ems- Date <br /> Principal Engineer Date ~ 3 ' fi d <br /> Facilities Mana er Date <br /> City Engineer~~ Date ~ ~ L.~` <br /> y <br /> FOR USE BY ADMINISTRATION ONLY <br /> Capital Project No. ~ u~ ACK 53, ~XXX X,. q 5 ~ 3 to <br /> GL Title _ ~ ~ _ <br /> Assigned y Date / <br /> Accounting by _ Date <br /> ATTACHMENTS: ~ .~~V ooU <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 ? Map <br /> ? Request for Scoping Meeting <br /> ENG 415 WHITE /Finance YELLOW /Administration File PINK /Engineering File GOLDENROD /Project Manager ?UL Y2004 <br /> <br />