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PROJECT AUTHORIZATION FORM <br /> Engineering <br /> Public Works <br /> City of Eugene <br /> 244 E. Broadway <br /> Service ID: / G!~ ~ Eugene, OR 97401 <br /> <br /> " SID. pg ii GL ~JC ; OE t~ ~ (541) 682-5560 <br /> Project title: vV --rte J <br /> (location and work description) ~ ~ ~ (J <br /> Project <br /> m~ an <br /> g contact /private engineer: !"r c <br /> ti . <br /> PROJECT SCOPE: <br /> Paving: <br /> Concrete walks: (w~drns/ Bike lanes /paths: <br /> ' (iengrn) Setback /Curbside (widrn) <br /> Sanitary sewer (widrn/ <br /> Storm sewer <br /> Signal Landscaping <br /> Street lights <br /> New building construction ROW required <br /> Planning, other, hG~~.~;~„ <br /> Remodel <br /> FUNDING SOURCES: <br /> City jai; <br /> Assessments private <br /> Other department <br /> Fed /State /County /FAA Account code <br /> COMMENTS /SPECIAL PROJECT INFO. /INTERDEPARTMENTAL WORK DE <br /> fixed) <br /> s ~ ~ ~ SCRIPTION: <br /> ~ ( ~ ~ <br /> i <br /> APPROVED: <br /> Project Mana er <br /> ~s~w s~.,~-„ 9 , <br /> ~~~-F~^ua~r Date ~ _ t~ ~ <br /> Facilities Manager Date ~=l - ~ c ~~'Z <br /> 'C~-~~aee~ ~ . Date y ~ <br /> y~ ~^~y " " <br /> t'i ~ r. ~ is ie n. ~ <br /> ~ <br /> Date <br /> j <br /> FOR USE BY ADMINISTRATION f'" <br /> ~I~~~r ONLY <br /> Capital Project No. <br /> GL Title m e !d 1 <br /> 1`I <br /> Assigned y <br /> Date 7 ® I <br /> Accounting by <br /> Date <br /> ATTACHMENTS: <br /> ? Budget Estimate <br /> ? SDC Budget Worksheet ? Developer Agreement ;c " <br /> ?Engineering Agreement ? Engineer's Report On Improvement Petition <br /> ? City Engineer's Initiating Order ? Public Improvement Permit Application ? Ma <br /> ? Engineering Service Work Request <br /> ? File Request Form <br /> p <br /> ENG 415 WHITE /Finance YELLOW /Administration File PINK /Engineering File GOLDENROD w <br /> /Project Manager ?ANUARY2000 <br /> i <br /> r <br /> } <br /> <br />