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PROJECT AUTHORIZATION FORM Engineering <br /> Public Works <br /> City of Eugene <br /> 244 E. Broadway <br /> / Eugene, OR 97401 _ <br /> Service ID: ~~33 SID PB ~ GL ? JC - JE _ (541) 682-5560 <br /> Project title: ~ ~ ~i~~ <br /> (locaGOn and work description) <br /> Project manager /contact /private engineer. N ~ ~ <br /> PRO.fECT SCOPE: <br /> Paving: Bike lanes /paths: <br /> (widins) (width) <br /> Concrete walks: Setback I Curbside <br /> penyrn) (widtn) <br /> Sanitary sewer Storm sewer Landscaping <br /> Signal Street lights ROW required <br /> New building construction Planning, other Remodel <br /> FUNDING SOURCES: _L~~35 ~Q~/ <br /> City Assessments Private Other department <br /> Account code <br /> Fed /State /County /FAA fixed) <br /> COMMENTS /SPECIAL PROJECT INFO. /INTERDEPARTMENTAL WORK DESCRIPTION: <br /> APPROVED: <br /> Project Manager Date <br /> Principal Engineer Date <br /> Facilities Manager Date <br /> City Engineer Date ,t/~S ~ Oy <br /> FOR USE BY ADMINISTRATION ONLY <br /> Capital Project No. ~~J °~SO~ ACK 1 4335 XXXXX ~/`,rO?•~O~ <br /> GL Title m / ~ ~h Pr~~ <br /> Assigned by ~ Date ~ ~ <br /> Accounting by Date <br /> ATTACHMENTS: <br /> Estimate ? Developer Agreement ? Engineer's Report On Improvement Petition <br /> ~C~~] B get Worksheet ? Engineering Agreement ? Engineering Service Work Request <br /> ~~"b~"`ngi eer's Initiating Order ? Public Improvement Permit Application ? Map <br /> <br /> V rFlle Re st Form <br /> pE~N~G 415 WHITE /Finance YELLOW /Administration File PINK /Engineering Fle GOLDENROD /Project Manager JANUARY 2000 <br /> " <br /> t ~ <br /> <br />