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PROJECT AUTHORIZATION FORM Engineering <br /> Public Works <br /> City of Eugene <br /> / 244 E. Broadway <br /> r^iA!f'iS ~,~~"~s Eugene, OR 97401 <br /> Service ID: ~ D ~ ~ V/ ~ / (541) 682-5560 <br /> SID_ PB _ GL _ JC _ JE _ <br /> Project title: ~ ~~,~~~J ~'1~ 1,AE"C6~l~ <br /> (location and work description) <br /> Project manager /contact /private engineer: ~~V 11...E ~ & F..~1..9~ E.Y <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 Da <br /> Signal Street lights ROW required ~ <br /> New building construction Planning, other Remodel <br /> 'FUNDING SOURCES: C-13.5 ~ ~ <br /> City Assessments Private Other department <br /> ~1~ Account code <br /> Fed /State /County /FAA fixed) <br /> COMMENTS /SPECIAL PROJECT INFO. /INTERDEPARTMENTAL WORK DESCRIPTION: <br /> ~~.c,~ ~k~~ ~a,~®~. ITT ~d~~ ~I~~ c,¢.~~~C.16~ <br /> ~~YBER~_~'~~~,-~-~+~, m ~c~~n~~8~ ~~i l T W 9l~ <br /> D yV a <br /> APPROVED: <br /> Project Manager Date ~ ~ ` ~ ~ `®Vr <br /> Principal Engineer Date <br /> Facilities Manager Date <br /> City Engineer Date " 2 <br /> FOR USE BY ADMINISTRATION ONLY <br /> Capital Project No. ~J ~ ACK ~ ~ ~/5 ~ 7 <br /> GL Title ~/L, ~l T~~' J~/~-' ~'~f <br /> Assigned by ~ Date ll ~ <br /> ~ LiAccounting by Date ~ ~ <br /> ATTACHMENTS: <br /> ,,Budget Estimate ? Developer Agreement ? Engineer's Report On Improvement Petition ~ <br /> <br /> ~I SDC Budget Worksheet ? Engineering Agreement ? Engineering Service Work Request a <br /> ? City 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 NUa ~~'r" _ _ ~ <br /> ~ <br /> _ <br /> <br />