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PROJECT AUTHORISATION FORM Engineering <br /> Public Works <br /> City of Eugene <br /> • 244 E. Broadway <br /> Eugene, OR 97401 _ <br /> / (541) 2-5560 <br /> Service ID: SID ~ PB ~ GL ~ JC ~ JE V <br /> Project title: _CiVV'e ~ ~Z ~ <br /> (location and work d caption) <br /> Project manager /contact /private engineer: ~~lr~T~V?~~ <br /> PROJECT SCOPE: <br /> ~I <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 Remodel <br /> FUNDING SOURCES: ~~dl,e.''.5~ <br /> City,/,,~? Assessmen s Private Other department <br /> iii-~~?,ylaad,~' Account code <br /> Fed /State /County /FAA fixed) <br /> COMMENTS /SPECIAL PROJECT INFO. /INTERDEPARTMENTAL WORK DESCRIPTION: <br /> t 6tir l/VL(-i.- t~ l~ l~ L~(~Coi~ V1~ ~1~~1~ ~A'1`~S ~'f T`~%~- <br /> <br /> ~ ~ P~ ~ ~ ~t.¢e~. <br /> APPROVED: <br /> Project Manager at~~~ ~ <br /> Principal Engineer ate 2~.~~'~~ <br /> Facilities Manager Date <br /> City Engineer Date Z~Z/~~ 2 <br /> FOR USE BY ADMINISTRATION ONLY <br /> ,ate <br /> Capital Project No. ~ ACK ~n~~' ~3~~` 1~~~~X - ~3~ <br /> °?~a <br /> GL Title ~'~/i/ /G'-l~ ,d'/L ~ ~Cc.+Ylfe,~ f <br /> Cep <br /> Assigned by ~ Date o2"a~ 5. 0.3 <br /> Accounting by ~ Date ~ - Z~ "~3 <br /> ATTACHMENTS: <br /> Budget Estimate ? Developer Agreement ? Engineer's Report On Improvement Petition <br /> • ? SDC Budget Worksheet ? Engineering Agreement ? ,Cngineering Service Work Request <br /> ? Ity Engineer's Initiating Order ? Public Improvement Permit Application Map <br /> LI File Request Form <br /> ENG 415 WHITE /Finance YELLOW /Administration File PINK /Engineering File GOLDENROD /Project Manager JANUARY 2000 <br /> <br />