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. _ _ <br /> ~ - <br /> Facility Management <br /> P~RsO:~E~TAUTHORIZATION FORM Central services <br /> ~ City of Eugene <br /> Service <br /> D (Good Job Number) ~l.~~g 210 Cheshire Avenue <br /> Eugene, OR 97401 <br /> (541) 682-2690 <br /> Project Title: <br /> Dept/Div and work descnption. Example: LRCS Campbell Center Reroof ~ <br /> <br /> ~ Project Manager: ~ <br /> PROJECT SCOPE: Planning Remodel New building construction Energy <br /> FUNDING SOURCES: Fund Org Project ~ <br /> General Fund CIP Category: <br /> Federal orothersources: r T' ®3 (~l~/~~/ ~ ~y j~/,,tf,~~ ~ fixed) <br /> COMMENTS /.SPECIAL PROJECT INFO /INTERDEPARTMENTAL WORK DESCRIPTION: <br /> APPROVED: <br /> Project Manager Date <br /> Section Manage Date 3 ©2 <br /> Division Manager Date ~ <br /> ~ ~ ~ ~ <br /> FOR USE BY ADMIN n ~ ~ 9 n <br /> Capital Project No. `'I 3~ ~ l3 ACK 7'3 ~J' <br /> 1' ~(,x~C-~ `7,~ J <br /> Q/~ <br /> G L Title / ~°{y1 / I~IC~,~ /l..C~ f~ /L~E ~ ~ <br /> Assigned by gate ~j~ ~ <br /> T <br /> ATTACHMENTS ? Budget Estimate ?CIP Spreadsheet ? ADATransition Plan <br /> WhRe -Office Fle Yellow -Project Manager Rev. 0901 <br /> <br />