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I t~ Engineering <br /> PROJECT AUTHORIZATION FORM Public Works <br /> , City of Eugene <br /> <br /> ~ ~ 858 Pearl <br /> Eugene, OR 97401 <br /> (541)682-5291 <br /> Service ID: ~ SID ~PB ~ GL ~ JC ~ JE <br /> Project title: <br /> ocahon an wor aescn hon ~ t <br /> ~ Project manager /contact /private engineer: <br /> I <br /> PROJECT SCOPE: <br /> Paving: Bike lanes /paths: <br /> ~wiarns/ /w<arn/ <br /> Concrete walks: b/ Setback /Curbside <br /> ~ (length) (width) <br /> Wastewater Stormwater ~ ~ Landscaping , <br /> Signal Street lights _ ROW required `f <br /> New building construction Planning, other S ~ Remodel <br /> 'I <br /> FUNDING SOURCES: - <br /> City Assessments Private Other department <br /> Account code <br /> ,I Fed /State /County /FAA fixed) <br /> COMMENTS /SPECIAL PROJECT INFO. / INTERDEP MENTAL WORK DESCRIPTION: <br /> i <br /> ~ <br /> i <br /> APPROVED: <br /> Project Manager ~ ~ P~J Date ~ ~ ~ ~ <br /> ~ Principal Engineer ' Date <br /> . Facilities Manager Date / ~ ~ <br /> ' City Enginee ~ Date ~ Z a ° <br /> FOR USE BY ADMINISTRA22TION,/+-ONLY ~l p' <br /> Capital Project No. ~ ACK r0 ~ ~ ~ s7 ~ CIa ~ ~ Y <br /> GL Title ~t~,~'~ Y- f (x ~'~'~'LC~~ <br /> Assigne y Date / ~ ~ " <br /> v~ <br /> Accounting y Date <br /> ATTACHMENTS: <br /> ? Budget Estimate ? Developer Agreement ? Engineer's Report On Improvement Petition <br /> ? SDC Budget Worksheet ~ gineering Agreement ? Engineering Service Work Request <br /> ? City Engineer's Initiating Order `Public Improvement Permit Application ? Map <br /> File Request Form <br /> 1 2 2 <br /> WHITE /Finance YELLOW /Administration File PINK / En ine ri File GOLD N D°/ Pro'ect,M na er FEBRUARY OD <br /> ENG415 9 ~ a~„-~,~ ~ ~Oi ,J a 9 <br /> " ~ <br /> <br />