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PROJECT AUTHORIZATION FORM Engineering <br /> Public Works <br /> City of Eugene <br /> /`~/~JZ- 244 E. Broadway <br /> ~~j (541) 6820- <br /> 560401 <br /> Service ID: SID PB _ GL _ JC ~ JE _ <br /> Project title: t tD ~ i~ 0~ ~4'@ ~ t.! I ~ j <br /> ~ ~aa e,,. i <br /> ~ i~v° ~'e ~>F`- <br /> (location and work description) <br /> Project manager/ contact /private engineer: ~"G~ ~ <br /> PROJECT SCOPE: <br /> Paving: Bike lanes /paths: <br /> (widths) (width) <br /> Concrete walks: Setback /Curbside <br /> (length) r width) <br /> Sanitary sewer s Storm sewer t? S Landscaping <br /> Signal Street lights ROW required <br /> New building construction Planning, other Remodel <br /> FUNDING SOURCES: <br /> City Assessments Private Other department <br /> Account code <br /> Fed /State /County /FAA fixed) <br /> COMMENTS /SPECIAL PROJECT INFO. / I~N^TERDEPARTMENTAL WORK DESCRIPTION: <br /> ~ <br /> c /lJtf' ~ Opt /tom e%.'jL.~ /t <br /> t <br /> -j s,. <br /> T fec/$ <br /> ~ eta i <br /> APPROVED: <br /> Project Man <br /> ~ ager Date c~ ~ <br /> Principal Engineer Date (CL <br /> Facilities Manage Date <br /> City Engineer --t-' Date 1-`~ ~l <br /> --e <br /> FOR USE BY ADMINISTRATION ONLY <br /> Capital Project No. ~ ~ ACK Z" ~ ~ ®2~ <br /> GL Title Y~~~'t~ ~ 1 <br /> Assigned by ~ f ~ Date D ~ <br /> Accounting by ~ lsL Date ~~Z~/~J <br /> ATTACHMENTS: <br /> <br /> j Budget Estimate ? Developer Agreement ? Engineer's Report On Impne P <br /> SDC Budget Worksheet ? Engineering Agreement Engineering Service Wo Re test <br /> ? Clty Engineer's Initiating Order ? Public Improvement Permit Application Map ~ <br /> File Request Form ~ <br /> ENG 415 WHITE /Finance YELLOW /Administration File PINK /Engineering File GOLDENROD /Project Manager ~ °-~~ANU~,??'®2^~0 <br /> <br />