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~ <br /> ,,~7 Public Works <br /> Project Number Request ~`1 ~dr. ~ ~ ~ Engineering <br /> 858 Pearl Street <br /> Job No. o ~ ~ _ ene, OR 97401 <br /> Project title: _ _~i~r <br /> (location and work description) - ° <br /> Project manager /contact /private engineer: Ni t iC-~ s5,-~3T2_ ~ ~t <br /> ° :gym <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 ,mac Remodel <br /> FINDING SOURCES: <br /> it~~`~~ssessments Private Other department <br /> Fed /State /County /FAA _ fixed) <br /> COMMENTS /SPECIAL PROJECT INFO. /INTERDEPARTMENTAL WORK DESCRIPTION: <br /> J l "`ii <br /> _ 6 <br /> C~ <br /> f~t~ ~ <br /> ~ A~ _ <br /> t <br /> o L <br /> - <br /> - - <br /> - <br /> APPROVED: <br /> <br /> III <br /> Project Manager ~ Date ~~S 1 ~ /C+~= <br /> Principal Engineer Date <br /> F~rfies Manager ~ Date . ~ ~ <br /> City Engineer Date G <br /> _ FOR USE BY ADMINISTRATION ONLY <br /> Capital Project No. ~ ~ PtP'I~ <br /> Assigned by A~- Date ~ <br /> Accounting by n ~ ~ Date ~ ~ ~ a- <br /> ATTACHMENTS: <br /> ? Budget Estimate ? Developer Agreement ? Engineer's Report On Improvement Petition <br /> ? Engineering Agreement ? Engineering Services Work Request ? Map <br /> ? City Engineer's Initiating Order ? Public Improvement Permit Application <br /> ~/89 WHITE /Finance YELLOW /Administration File PINK /Engineering File GOLDENROD /Project Manager <br /> _ _ <br /> <br />