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Vd <br />~ <br />PROJECT AUTHORIZATION FORM <br />Engineering <br />Public Works <br />City of Eugene <br />244 E. Broadway <br />Eugene, OR 97401 <br />~ (541)682-5560 <br />Service ID:_ ~~~~ SID~PB _ GL _ JC = JE ~ <br />Project title: _ ( ,~ , y 1"~~%~j~ <br />(/ocation and wo~k desciiptionJ <br />Project manager / contact / private engineer: <br />PROJECT SCOPE: <br />Paving: _ 4~~~ <br />Concrete walks: <br />Wastewater <br />0 <br />i °, /" ~ (widlh <br />----~~~ Stormwater ~ C Landscaping <br />Signal Street lights _ <br />New building construction Planning, other <br />FOR USE BY ADMINISTRATION ONLY <br />Capital Project Na .~ @ ~ ACK ~~ ~ ~ ~ -~ , ~ ~ <br />FUNDING SOURCES: <br />City Assessments Private <br />Fed / State / County / FAA <br />COMMENTS / SPECIAL PROJECT INFO. / INTERDEPARTMENTAL WORK DESCRIPTION: <br />APPROVED: <br />Project Manager_ <br />Principaf Engineer <br />Facilities Manager <br />City Engineer~ <br />~ <br />Bike lanes / paths: <br />(widlhJ <br />Setback / Curbside <br />ROW required. <br />Remodel <br />Other department <br />Account code - <br />( %, fixed) <br />Date ~ <br />Date ~ 3 <br />Date <br />Date s,~~0~' <br />GL Title ~~~Y\, ~- ~ <br />Assign by Date ~ e~ ~ <br />Accou ' y <br />Date <br />ATTACHMENTS: <br />i. ^ Budget Estimate ^ Developer Agreement ^ Engineer's Report On Improvement Petition <br />^ SDC Budget Worksheet Engineering Agreement ^ Engineering Service Work Request <br />~ Rity Engineer's Initiating Order ~Public Improvement Permit Application ^ Map <br />equest for Scoping Meeting - ~ ~ <br />~ <br />ENG 415 WHITE / Finance Y E L L O W / Administration File PINK / Engineering File GOLDENROD / Project Manager /UL Y2004 <br />J <br />~ <br />~ <br />6" <br />--v <br />~ <br />'~ <br />~ <br />~ <br />