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„ •i.: .a;,.. LH.,. -,m+..., .v . duo. 7w l'Ht .x~eyF:ec~.: ~ -d,.. L::7itit!lt:. :'.°'M1~:i .:w. m . ..:ta.. • "ms's,,.,. <br /> _ <br /> ~ ~ + <br /> p c... <br /> . "~RI~J~~CT AUTHORIZATION FORM Ste' Engineering <br /> Public Works <br /> City of Eugene <br /> 244 E. Broadway <br /> ugene, OR 97401 <br /> ~~Q Q a// ` / r u`~541)682-5560 <br /> Service ID: ~J SID PB/ GL ~/JC JE "J 777 <br /> Project title: <br /> and esciiplio <br /> Project manager / cont ct /private engineer: <br /> ~ , <br /> <br /> f <br /> <br /> ~ PROJECT SCOPE• <br /> u <br /> Paving: ~ 1~ Bike lanes /paths: <br /> /widlhsJ /wio7hf <br /> i <br /> Concrete walks: Setback /Curbside <br /> (/e~th) (widlhJ <br /> Wastewater Stormwater Landscaping <br /> I <br /> ~I Signal Street lights ROW required <br /> New building construction Planning, other Remodel <br /> ' FUNDING SOURCES: ~ ~ (~3 ~C1 <br /> I <br /> City Assessments Private Other department <br /> / Account code <br /> n;~~d I <br /> Fed /State /County FAA fixed) <br /> Fl : COMMENTS /SPECIAL PROJECT INFO. / IPiT RDEPARTMENTAL WORK DESCRIPTION: <br /> l <br /> :.795'. <br /> 'y~::p <br /> k1 <br /> J <br /> / •j <br /> I ~ APPROVED <br /> ~ Project M~r~Q°~er, Date <br /> Principal Engineer Date ~ ~ ~ ~ rh ~ <br /> ~ Facilities Mana er Date <br /> ~ City Engine ~ Date ~'f~G~~ ~ <br /> i <br /> j <br /> ~ I FOR USE BY ADMINISTRATION ONLY <br /> ~t~~y~y ~ >>32 ~x x~~ g~ <br /> j Capital Project No. ACK 1 5y_T_ <br /> ~!i GL Title ~ ~ ~ ~ ~ ~ <br /> i p <br /> Assigned b ~ Date ~ <br /> Accounting by Date <br /> ATTACHMENTS: <br /> Budget Estimate ? Developer Agreement ? Engineer's Report On Improvement Petition <br /> SDC Budget Worksheet ? Engineering Agreement ? Engineering Service Work Request j <br /> i ? City Engineer's Initiating Order ? Public Improvement Permit Application Map <br /> ? Request for Scoping Meeting j <br /> ENG 415 WHITE /Finance YELLOW /Administration File PINK /Engineering File GOLDENROD /Project Manager ?UL Y2004 <br /> ~1 <br /> I <br /> I_____ _ J <br /> <br />