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, S <br /> i s 'i . <br /> ~ -~y <br /> PRQJECT AUTHORIZATION FORM ~ Engineering ~ <br /> Public Works <br /> ~ i <br /> ~ ~ I ~Y~L ~ City of Eugene { <br /> I ~ 244 E. Broadway <br /> Eugene, OR 97401 ~ <br /> ~ Service ID: 2 S ~ (541) 682-5560 <br /> ~ ~ ( SID 1~ PB y GL /L JC JE ~ <br /> Project title: a Aid ~ ~ at~~ ~o ~F i G <br /> pocalion ei~d ~ydrk descdption/ <br /> i <br /> ~ P ~ g <br /> J Ln3 a contact / rivate en ineer: u ~ t` i Ue <br /> PROJECT SCOPE: <br /> I I, <br /> I Paving: /wed/hsi Bike lanes /paths: <br /> + , n /widlhJ <br /> Concrete walks: N ~ ' ~"~l't ~r~-P~ C.~sr r-ec-S Setback /Curbside <br /> (/eng/hl (widlhJ <br /> Wastewater Stormwater Landscaping <br /> I'~, Signal ~ g ur 2 5 ~ u ~ Street lights ROW required oS5 ~ ~ ! <br /> V <br /> II New building construction Planning, other Remodel I~*~PS <br /> FUNDING SOURCES: M r~• ~~C X om,~33 ~ X331 Cot 7q~j ~i 3, 5K 3 3..2 ta,1?S"~t7St~4 ~ <br /> P ~-1.;'2 (~t"13S loa~~f?7 ~i~,1o~j," I <br /> City ~~Yl~S SDG Assessments Privat Other department ~d21 9x.35 lot ?9 ~f 9asvrr, i <br /> ~~°Io IK{C.~ wrr~sE~~oMn^u~~~~l.t~QC~~r'rin~ [~4~`9/rc L'~x r <br /> ov <br /> 1 ba <br /> Account code , lsS. f <br /> <br /> III / t 7 I <br /> <br /> i ~ Fed /State /County /FAA fixed) y S 9v <br /> COMMENTS /SPECIAL PROJECT INFO. /INTERDEPARTMENTAL WORK DESCRIPTION: ~3r yJa~•Gt1 <br /> M, ~ ~ , <br /> = r Z.C~ a, 1, <br /> ~ f <br /> Project Manager Date ~9 Z T <br /> Princi al En ineer ~ - 2 <br /> P ( 2 v <br /> g Date <br /> R <br /> Facilities Ma ta~ ' <br /> 9 Date <br /> Cit En ine ~ ~ <br /> e G <br /> y 9 D~te <br /> j <br /> 1~ I <br /> h65 I~~o„rJer - ~r ~ , ,~7) <br /> J. <br /> FOR USE BY AD <br /> MINI AT10 ONLY <br /> Ca ital Project No. ~ ~.1~~ 1-~3i3o~ <br /> P 1 - ACK LQx'K~k ~SSIoZ <br /> GL Title Cl/~ ~ fTl I Qr "~r(~'i 1 ( Irlt~/~,' <br /> i <br /> Assigned Date <br /> ' ~ ' <br /> ' I <br /> M , <br /> Accounti , b f ~ r } / <br /> n~ J <br /> Date <br /> 1 , <br /> i <br /> ATTACHMENTS: ~ ~ <br /> r '~j Budget Estimate ? Developer Agreement ? Engineer's Report On Improvement Petition i <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 Y7004 <br /> 1 <br /> i <br /> <br />