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hR(~J~CT AUTHORIZATION FORM Engineering <br /> Public Works <br /> City of Eugene <br /> 244 E. Broadway <br /> .~L~G/r°.S`,S~` r~/~'lS / Eugene, OR 97401 <br /> Service ID: ~ ~ SID PB GL ~ JC JE ? (541) 682-5560 <br /> Project title: r ~ ~ ~~v~~' ~tt~1 <br /> (14 ~..l~V ~pti V \ ~C~~ <br /> Project manager /contact /private engineer: <br /> PROJECT SCOPE: <br /> Paving: Bike lanes /paths: <br /> (widths) (width) <br /> Concrete walks: Setback /Curbside <br /> dl (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 /> <br /> ' ~ ' <br /> APPROVED: <br /> Project Manager Date-_-~~-~~ - <br /> Principal Engineer Date <br /> Facilities Manager Date <br /> City Engineer- _ Date ~ ~ ` <br /> FOR11 USE BY ADMINISTRATION ONLY <br /> Capital Project No. ~ 73~~ 7 ACK ~`~3Q ~ ~ X XX `~`~'.~~T <br /> GL Title /}I°i ae.l~ /->E-te~'~ q 9 /,c'f~ /C'eC~r~'e <br /> Assigned by ~ Date ~~~/D~ <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 /> L~File Request Form <br /> E/NG 415 WHITE /Finance YELLOW /Administration File PINK /Engineering File GOLDENROD /Project Manager JANUARY 2000 <br /> <br />