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PROJECT AUTHOR En ineerin <br /> ~ZATiON FORM g g <br /> Public Works <br /> City of Eugene <br /> 244 E. Broadway <br /> ' Eugene, QR 97401 <br /> r <br /> ~ X541 ~ 68~-5560 <br /> Service ID: SID PB OL ~ JC JE <br /> 3 ~ + <br /> Project title: <br /> (location and workdescrip~ianJ <br /> (/l~ <br /> 4 <br /> Project manager 1 contact 1 private engineer; ~ ~ W <br /> ±±E <br /> <br /> i! <br /> .PROJECT SCOPE: <br /> Paving: ~~d <br /> ~ ~ <br /> fwidlhs~ ke lanes paths. <br /> ~ ~width~ <br /> Concrete walks: Setba 1 C <br /> (lengthy urbSi!de <br /> width) <br /> wastewater Starmwater <br /> { ~ Landscaping <br /> Signal ~ Street li hts ~ ' <br /> g ROW required <br /> . New building construction Planning, other ~ Remodel <br /> FUNDING SOURCES: <br /> City ~ Assessments Private. <br /> Other department <br /> Account code <br /> Fed l State 1 County 1 FAA ~ o <br /> ~ ~ /p, fixed} <br /> COMMENTS 1 SPECIAL PROJECT INFO.IINTERDEPARTMENTAL WORK. DESCRIPTION: <br /> APPROVED: <br /> S• <br /> Project Manager ~ ~ ~ <br /> Date <br /> Principal Engine r Date ~ ~ <br /> Facilities Manager Date <br /> City Engineer ~ D <br /> ate <br /> FOR USE BY ADMINISTRATION ONLY , <br /> Capital Project No. ACK <br /> GL ~'itle <br /> Assigned by Date <br /> Accounting by ~ Date <br /> ATTACHMENTS: . <br /> ? Budget Estimate ? Developer Agreement ? En ineer's Re art <br /> g p , On Improvement Petlt~on <br /> CI SDC Budget Worksheet Engineering Agreement. ? En ineerin Service Work <br /> g g Request <br /> ? City Engineer's Initiating OrderPublic Improvement Permit Application ? Ma <br /> p <br /> ? Request for Scaping Meeting ~ , <br /> ENG 4~ 5 wF~ITE 1 Finance YELLQIN 1 Administration File PINK 1 Engineering File GDLDENRGD I Project Mana er JUL Y2DD4 . <br /> g <br /> <br />