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10/13/98 15:00 $96828410 <br />J ,~ <br />PROJECT AUTHORIZATION FORM <br />~~--- <br />Service ID: ~~-._~: <br />Project title: _ ,~'~l,t~° <br />rronrb-;.ra ~wr~r ara-/prfvnl <br />.., .....:..... _1 <br />rojeot mane /,contact /private <br />PROJECT SCOPE: <br />Paving: _ <br />Concrete wal15s:.._~ <br />Sanitary sewed <br />Signal <br />New building construoi <br />Fi;1NDiNG SO~JRCES: <br />City .. .....!~..--~-•- <br />ELTG PUBLIC WORKS i---+ ELTG PLIBLIC WORKS 0001/003 <br />393 <br />~~" Englnssrln8 <br />410 ~ ~~ n'1 ~ . public works <br />~f' t " Clty of Eugene <br />~~ ~ <br />~ ( <br />~ <br />~ 2d4 E. Broadway <br />Eugene, OR 97a0t <br />/ I W (541) 882.55811 <br />..~ <br />i i <br />_.._.._...~ r _.._.._....._.---_-•_-..._ 6lkelanes/pathl;:_~_..._.._. <br />~, _ .~~..-...._,,..,__ Setback 1 Curbside <br />lNnym/ rw+aru ./ --- <br />Storm sewer /~ Landscaping !-/ <br />Street lights .ROW required <br />______ Planning, other.___......... Remodel <br />Assessments ~ Private --..... _.._._.._ ..... Other department _._ .. ~ ....._.._. _ <br />Account code <br />Fed / S#ate / C~OUnty /FAA <br />COMMENTS / SP~CUIL PROJECT INFO. /INTERDEPARTMENTAL WORK DESCRIPTION: <br /> <br /> <br />( %, fixed) <br />APPROVED:' - - Q <br /> <br />Project Maner~er_ _......_ ._._ _ .. ~//~ <br />Date I ~- <br />Principal Engf~leer -----. - ., Date <br />Facilities Manger _ .... .. .........__. Date <br />Clry Englneen-. ----- .. .. ......._ Date <br />FOR USE 8Y ADMINISTRATION ONLY <br />Capital Proje4~t No. -. <br />GL Title -_:_.- <br />Assigned by . <br />Accounting by <br />ACK ... <br />Date <br />_. Data <br />A CNMENTS~ <br />tjdget Estima~e G~.1 Developer Agreement ^ Engineer's Report On Improvement Pethion <br />DC Budget orksheet ^I Engineering Agreement ^ Engineering Service Work Request <br />^ C Engineer' Initiating Omer ^ Public improvement Permit Application O Map <br />Ile Request Farm <br />ENG d15 WHITE / Finance YELLOW / AdminlstratlOn Flle PINK I Enplneerinp Flle OOLDENROC ! Profeot Manager MARCH 78A9 <br />