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f <br /> . <br /> t <br /> <br /> ~ ~ PF~OJECT AUTHORIZATION FORM ~ ~ Engineering <br /> ! Public Works <br /> ~ City of Eugene <br /> 244 E. Broadway <br /> ~ ~~ti' Eugene, OR 97401 <br /> ,r' r . (541) 682-5560 <br /> Service ID: - '0Q Z-~~ SID PB br GL _ JC ~ J~'~_ <br /> Project title: h!~ t T~~('~t..~ <br /> [7~I~A~~- r-, >E~~_QA-~I <br /> pocahon and wodcdescnptwn) <br /> Project manager /contact /private engineer. ~ <br /> ~ ! ~ p,,..l F~1,~`-/• <br /> PROJECT SCOPE: ~ ~1vA~t+,~c SP~C..~ S ~.~b~,c1`rA ~ , K~V~(~ ~Vu R..h=. Gv; ~i c7~ ~a~ c ~i~-~~~~y <br /> ~'~A:t~c.'1" AIJ b (,i N M ltt'r'C N ~ C3lr~ F71~~,:~.C..T• I.`I•, P~,t~~ ~ F~~~. ~ R ~~*/A ~ :~lC-Y <br /> among: I e ran s /Maths: <br /> (~h) <br /> Concrete walks: Setback /Curbside <br /> (ten9tn) (~dtn) <br /> Sanitary sewer Storm sewer Landscaping <br /> Signal Street lights ROW required <br /> New building construction Planning, other Remodel <br /> FUNDING SOURCES: ~~a ea a 53 ! ~=.~=r~t..~ .~1`y~ ;(y G ~i `s ~ ~t ; <br /> City}t Assessments Private Other department <br /> 't' Account code <br /> Fed /State /County /FAA fixed) <br /> COMMENTS /SPECIAL PROJECT INFO. /INTERDEPARTMENTAL WORK DESCRIPTION: <br /> 3 fw t I L T t~-~-< P~~. t~r'x~T"~; ; k,.A-C" t a`-1t..! FZE~ L.4rt° ir-_x"~ ~ ,C~ .i.~~;` ~ <br /> •7~Itr rte- -r t~ ~ n'N b F~' R! t '1"" .';"~-1~4Y l~„ R ~Jd't' M F~~r"..4~~ A'i~ ~ e~ <br /> ~a l..in~@ ~U R t-r~-1 ~ ~t ~ R r-ty ~ RPM. <br /> ' APPROVED: <br /> Project Manager ~'ti-~- fi----~-- Date ~ <br /> Principal Engineer ~ ' Date ~ ` (2° <br /> Facilities Manage Date <br /> City Engineer - Date ? r ` <br /> FOR USE BY ADMINISTRATION ONLY <br /> Capital Project No. ACK - <br /> GL Title C~.. 1 ~-F' t-, v ~ ~ ~ t,,~~r r - L.~ ~1 TC_ <br /> r` ~ ' ~ _ <br /> Assig~d b t Date O`~ <br /> Accounting by Date <br /> ATTACHMENTS: <br /> Budget Estimate ? Developer Agreement ? Engineer's Report On Improvement Petition <br /> ? SDC Budget Worksheet M~'C ? Engineering Agreement ? Engineering Service Work Request <br /> ? City Engineer's Initiating Order ? Public Improvement Permit Application ? Map <br /> ? File Request Form <br /> ENG 415 WHITE /Finance YELLOW /Administration File PINK /Engineering File GOLDENROD /Project Manager JANUARY 2000 <br /> <br />