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~ <br /> ~ rr;~a~,~y <br /> ROJECT UTHORIZATION FORM Publ c Wor <br /> k j <br /> City of Eugene <br /> <br /> ' 858 Pearl <br /> Eugene, OR 97401 <br /> / ~ j~ (541) 682-5291 <br /> ervice ID: ~ ~ ~ SID ~PB JC GL JC V JE f <br /> Project title: ~ ~ (Jl~ ~ Su u ~ ~ ~ S ~ 0 l~'~.` <br /> (1 on and.work description) ~ ,/dam ~ _ <br /> nd , lit /d fe a_ <br /> J__~~ ~'~/~_t~l/~L--_~~~ /r ~ <br /> Project manager /contact /private engineer: Dolt, vt V!~ 1 G4 T <br /> PROJECT SCt~PE: <br /> Paving: Bike lanes /paths: <br /> (widths) (width) <br /> Concrete walks: Setback /Curbside <br /> (length) (width) <br /> Wastewater Stormwater Landscaping <br /> Signal Street lights ROW required <br /> New building c nstruction Planning, other Remodel <br /> FUNDING SOURCES: <br /> City Assessments Private Other department <br /> Account code <br /> I ~ • : , Fed /State / C~unty /FAA fixed) <br /> t <br /> COMMENTS / SP CIAL PROJECT INFO. /INTERDEPARTMENTAL WORK DESCRIPTION: <br /> j APPROVED: _ _ <br /> Project Manager Date ~ L•' <br /> Principal Engi eer Date <br /> Facilities Man ger Date <br /> City Engineer r •~:(~-___a-- Date ~ ~ <br /> FOR USE BY ADMINISTRATrhON ONLY •-7 <br /> Capital Projec No. ~ ~ T ~ ACK ~3 ~ 3.~~ ~ xXX X ~ / ~'''3'~ <br /> GL Title ,~--f,~)'1ti° ~ ?!~(lTY'~ <br /> ~ ` . ?'~'~,.wY' Date ' ~ d M1~r <br /> Assigned by <br /> Accounting b Date <br /> ATTACHMENTS: <br /> ? Budget Estimate ? Developer Agreement ? Engineer's Report On Improvement Petition <br /> ? SDC Budget W' rksheet ? Engineering Agreement ? Engineering Service Work Request <br /> ? City Engineer's Initiating Order ? Public Improvement Permit Application ? Map <br /> ? File Request F rm <br /> I ENG 415 ~ WHITE /Finance YELLOW /Administration File PINK /Engineering File GOLDENROD /Project Manager FEBRUARY 2002 <br /> i <br /> <br />