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x <br /> PROJECT AUTHORIZATION FORM ~ Engineering <br /> i Public Works <br /> I <br /> 1 ~ - - City of Eugene <br /> ~ 858 Pearl <br /> Eugene, OR 97401 <br /> (541) 682-5291 <br /> Service ID:_ ~ ~ ~ SID ~ PB ~GL ~JC JE <br /> Project title: ' ~ z~ <br /> Qocation an work des ptlon) <br /> Project manager /contact /private engineer: _ ~ ~ ~ <br /> ~ PROJECT SCOPE: <br /> Paving: <br /> (wldrns) Bike lanes /paths: <br /> <br /> ~ Concrete walks: (widrn) <br /> (length) Setback /Curbside <br /> (width) <br /> Wastewater Stormwater <br /> Landscaping <br /> Signal Street lights ROW required <br /> ~'°9't~:~ . <br /> New building construction Planning, other ~ f~ ~ "I ~ 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- I <br /> Principal Engineer Date ~ d <br /> Facilities Manage Date <br /> City Enginee ' Date z~~'~~-- <br /> FOR USE BY ADMINISTRATION ONLY <br /> Capital Project No, ACK X~C`~C j~~~~~ 1 <br /> GL Title r'1 1'~ ~ ~ (.d~'~~'+ ~ ~Ur'~ ` ~j ~ <br /> Assi ned <br /> 9 Y I <br /> Date <br /> Accounting by Date <br /> ~ ATTACHMENTS: p <br /> ;i ? Budget Estimate ? Develo er A reement <br /> P 9 ? Engineers 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 /> t° Request Form <br /> tk <br /> ENG 415 WHITE /Finance YELLOW /Administration File PINK /Engineering File GOLDENROD /Project Manager FEBRUARY 2002 <br /> <br />