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PROJECT AUTHORIZATION FORM Engineering <br /> Public Works <br /> r~ C~'i~~ J City of Eugene <br /> 244 E. Broadway <br /> - Eugene, OR 97401 _ <br /> Service ID: G~ / (541) 682-5560 <br /> SID PB ~ GL ~ JC JE - <br /> Projecttitle: ~ ~ <br /> (/ocahon and work description) <br /> Project manager /contact /private engineer: N v~____ <br /> PROJECT SCOPE: <br /> .Paving: Bike lanes /paths: <br /> (widths) (width) <br /> Concrete walks: Setback /Curbside <br /> (length) (width) <br /> Sanitary sewer Storm sewer Landscaping <br /> Signal Street lights ROW required <br /> New building construction Planning, other Remodel <br /> FUNDING SOURCES: ~ ~ <br /> City PAS Assessments Private Other department <br /> Account code <br /> Fed /State /County /FAA fixed) <br /> COMMENTS / SPECIAL P OJECT INFO. /INTERDEPARTMENTAL WORK DESCRIPTION: <br /> <br /> 1 <br /> APPROVED: <br /> Project Manager Date <br /> Principal Engineer Date <br /> Facilities Manager Date <br /> City Engineer Date ~~~/5 ` <br /> FOR USE BY ADMINISTRATION ONLY <br /> Capital Project No. 9~ 5~5a ACK .~a ~ 4335 X XXXX ~l5'"a.5a <br /> GL Title m ~ 1 ~h Pa~c <br /> Assigned by ~~-ti Date ~ ~ <br /> ,Accounting by ~ Date I r I <br /> ~~'7~ <br /> ATTACHMENTS: <br /> ~ Bud et Estimate ? Develo er A reement <br /> 9 p g ? Engineer's Report On Improvement Petition <br /> SDC budget Worksheet ? Engineering Agreement ? Engineering Service Work Request <br /> _J City Engineer's Initiating Order ? Public Improvement Permit Application ? Map <br /> i~il~e Request Form <br /> ErdG 41 ~ WHITE /Finance YELLOW /Administration File PINK /Engineering File GOLDENROD /Project Manager JANUARY 2000 <br /> <br />