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PROJECT AUTHORIZATION FORM Engineering <br /> Public Works <br /> City of Eugene <br /> ? 244 E. Broadway <br /> A~CEE$S Eugene, OR 97401 <br /> (541) 682-5560 <br /> Service ID: SID PB ~ GL V JC ~ JE Nl~' <br /> Project title: ~l ~ ~ w ~ <br /> (location a y w/o_ rkrdescription) <br /> Project manager /contact /private engineer: ~U' <br /> PROJECT SCOPE: <br /> Paving: Bike lanes /paths: <br /> (widtns) (widrn) <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 Assessments Private_ Other department <br /> Account code <br /> Fed /State /County /FAA fixed) <br /> COMMENTS /SPECIAL PROJECT INFO. /INTERDEPARTMENTAL WORK DESCRIPTION: <br /> APPROVED: ( ~ <br /> Project Manager Date <br /> Principal Engineer Date <br /> Facilities Manager Date <br /> City Engineer Date 1 <br /> ~ ~ <br /> FOR USE BY ADMINISTRATION ONLY <br /> Capital Project No. 373900 ACK (~31 4330 ~C~C~CXX 3734D(A <br /> GL Title - /-tVCI,~ Ort V f ~ ~QAC~ r ~1~St°, <br /> Assigned by ~ Date ~'~Z-/DD <br /> ~f it <br /> Accounting by Date <br /> ATTACHMENTS: <br /> ? Budget Estimate ? 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 ? Map <br /> ? File Request Form <br /> <br /> ENG 415 WHITE /Finance YELLOW /Administration File PINK /Engineering File GOLDENROD /Project Manager JANUARY 2000 <br /> _ _ _ <br /> <br />