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` <br /> ~ h <br /> ~ 7,~~I->iOJECT AUTHORIZATION FORM Engineering <br /> Public Works <br /> ~ ~ City of Eugene <br /> ~ / f 244 E. Broadway <br /> / / / ~ / (541) 6820-5560401 <br /> Service ID: ~~T.) SID PB GL JC Y- JE <br /> ~ M LL/ 3 ~ . Sibi~~~rly i iM~ey~~t~Yl <br /> I ~ Project title: <br /> ! //ocalion and work descnptionJ <br /> Project mana er /contact / rivate en ineer: <br /> j I 'PROJECT SCOPE: <br /> I <br /> ~ (Paving: (widths) Bike lanes /paths: <br /> (width) <br /> ;(Concrete walks: Setback /Curbside <br /> (/engthf (width/ 1 i <br /> ~ NVastewater Stormwater ~~J Landscaping <br /> ~ Signal Street lights ROW required <br /> ,New building construction Planning, other Remodel <br /> i FUNDING SOURCES: <br /> ` City Assessments Private Other department <br /> Account code <br /> = Fed /State /County /FAA fixed) <br /> COMMENTS /SPECIAL PROJECT INFO. /INTERDEPARTMENTAL WORK DESCRIPTION: <br /> ~ ~1~~~1 pQy ~n1F w o U <br /> I ~ ~ <br /> iAPPROVED: - .Y <br /> 1 !Project Manager Date <br /> ~ ~ (Principal Engineer Date ~ <br /> I I (Facilities Manager Date ~ <br /> i <br /> ~ i City Engineer Date ~ U,f ~ <br /> FOR USE BY ADMINISTRATION ONLY <br /> Capital Protect No. ACK <br /> I <br /> ~ ~ ~ _ ~ <br /> I !GL Title <br /> i ~~l 6 <br /> iAssig d by Date <br /> i <br /> <br /> I <br /> Accoun y Date <br /> i I ATTACHMENTS: <br /> Budget Estimate ? Developer Agreement ? Engineer's Report On Improvement Petition <br /> ~ SDC Budget Worksheet ? Engineering Agreement ? Engineering Service Work Request <br /> i~ City Engineer's Initiating Order ? Public Improvement Permit Application ? Map <br /> 1 Request for Scoping Meeting __,j.~... /~1,~~( ~ ~ ~7 <br /> j NG 415 WHITE /Finance YELLOW / Administtr--ation File PINK / Engineerin File GOLDENROD /Pro ect Mana er ?UL Y2004 <br /> 9 1 9 <br /> i <br /> i <br /> <br />