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r <br /> PROJECT ~AUTHORiZAT10N FORM Fubi <br /> ~ wo 9 <br /> City of Eugene <br /> ~ <br /> ~ ~ ~ ~ 244 E. Broadway <br /> Eugene, OR 97401 <br /> ~ (541)682-5560 <br /> Service ID: SID PB GL JC ~ JE _ <br /> Project title: ~ ~ j ~ 'T~ ~ ~~~~-`r~ <br /> (bcation and work description) <br /> Project manager /contact /private engineer: ~ ' h') ~ ~ ~ fi <br /> PROJECT SCOPE: <br /> Paving: Bike lanes /paths: <br /> (widrn) <br /> Concrete walks: Setback /Curbside <br /> (i®~n) (widen) <br /> Sanitary sewer Storm sewer Landscaping <br /> Signal Street lights ROW required <br /> New building construction Planning, other Remodel <br /> FUNDING SOURCES: .~o`1t' • ~J,33S-'7~51 <br /> City ~ Assessments Private Other department <br /> Account code <br /> Fed /State /County /FAA fixed) <br /> COMMENTS / SPECIAL P t JECT INFOrr-~.-'/ INTERDEPARTMENTAL WORK DESCRIPTION: <br /> 1 <br /> 1 <br /> APPROVED: <br /> Project Manager ~ ~ Date <br /> Principal Engineer Date <br /> Facilities Manager Date <br /> City Engineer Date -,~L- ~5 ' ~ y <br /> FOR USE BY ADMINISTRATION ONLY <br /> Capital Project No. 1 5~ ACK / 9335 X ,~1~.,~x ,y 5 <br /> GL Title r r~ ! ~ ~7r n ~l~ ~ <br /> Assigned by ~ ~ ~ c~ Date ~ ~ ~ ~C~ <br /> Accounting by Date <br /> ATTACHMENTS: <br /> t Estimate ? Developer Agreement ? Engineer's Report On Improvement Petition <br /> S et Worksheet ? Engineering Agreement ? Engineering Service Work Request <br /> gi er's Initiating Order ? Public Improvement Permit Application ? Map <br /> ur R ~lil e t Form <br /> ENG 415 WHITE /Finance YELLOW /Administration File PINK /Engineering File GOLDENROD /Project Manager JANUARY 2000 <br /> <br /> 1 <br /> <br />