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PROJECT AUTHORIZATION FORM englneering <br />Public Works <br />.,\ .\ City of ugene ~ <br />244 .Broadway <br />E ene, OR 97 <br />,^, 41 682-55 <br />Service ID: ~ ~5 ~ ~ `^ SID /~ PB GL ~JC JE <br />Project title: ~~ ~- b 61 V <br />pacation and wodr descdptionJ t ~ <br />roject mana ntact /private engineer: <br />PROJECT SCOPE: <br />Paving: <br />(widths) <br />Concrete walks: <br />(/engfhJ <br />Wastewater Stormwater - <br />Signal Street lights <br />New building construction Planning, other <br />FUNDING SOURCES: <br />City Assessments <br />Fed /State /County /FAA <br />COMMENTS. /SPECIAL PROJECT INFO. / <br />ike lanes /paths: <br />(width) <br />Setback /Curbside <br />(width/ <br />Landscaping ~ <br />ROW required <br />Remodel <br />Other partment ~bS <br />Acc unt code coo ~ <br />( %, fixed), <br />ENTAL WORK DESCRIPTION: <br />~ - - - - - - <br />APPROVED: f o , ~ d8 ~ I <br />Project Manager Date !X <br />Principal Engineer Date 1~~ <br />Facilities Manager ~. ` Date p( <br />., , <br />City Engineer ~%'%` ~~ Date ~~ Z?' ~~'~ ~ <br />Capital Project No. <br />GL Title <br />Assigned by <br />Date <br />~ nn ACK _~ <br />., e ~ .1~ ,.,, ~ ~ ` ~ en <br />Date <br /> <br />Z ~o <br />J <br />g ^ Developer Agreement ^ Engineer's Report On Improvement Petition <br />^ SDC Budget Worksheet ^ Engineering Agreement ^ Engineering Service Work Request <br />^ City Engineer's Initiating Order ^ Public Improvement Permit Application ~~llap <br />^ Request for Scoping Meeting ` ~j ~ ` -s <br />iv-~z3 ~- ~c~ti~ ~ ,~~d~G~~ ~ 5 <br />ENG 415 WHITE /Finance YELLOW /Administration File PINK /Engineering File GOLDENROD /Project Manager /UL Y2004 <br />ATT~-CHMENTS: <br />Bud et Estimateet Estimate <br />FOR USE BY ADMINISTRATION ONLY <br />