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<br /> a' ~ ' <br /> • PRO~EC~" AUTHORISATION FORM ~ ~ Engineering <br /> Public Works <br /> City of Eugene <br /> - ~4~ E. Broadway <br /> Eugene, OR 97'401 <br /> X541 ~ X82-55G0 <br /> Service lD: SID PB GL JC JE <br /> Project title: ~ ~ ~ " <br /> (,oca bn arrd warkdesignJ <br /> d <br /> • ~ <br /> Project manager I contact 1 private engineer: ~~d ~ ' <br /> ' PROJECT SCOPE: <br /> Paving: ~ Bike lanes 1 aths: - ~ <br /> k <br /> (widths) ~ (widfh~ <br /> Concrete walks: ~ 5etbac urbside <br /> r1e ~ <br /> Wastewater <br /> Stormwater Landscaping <br /> Signal Street lights ROW required . <br /> New buildin construction PI ~ ~ ~ <br /> g ann~ng, other ~edel~ <br /> FUNDING SOURCES: . <br /> City Assessments Private Other department <br /> Account code <br /> Fed !State 1 County !FAA ~ °l~; fixed} <br /> COMMENTS 1 SPECIAL PROJECT INFO. !INTERDEPARTMENTAL WORK DE5CRIPTION: <br /> t <br /> APPROVED: <br /> Project Manage t ~ <br /> Date <br /> Principal Engin, er ~ Date <br /> Facilities Manager Date <br /> • City Engineer Date <br /> • <br /> FOR USF BY ADMINISTRATION ONLY <br /> . Capital Project No. ACK <br /> GL Title <br /> . Assigned by ~ Date • <br /> Accounting by Date <br /> • ATTACHMENTS: <br /> ? Budget Estimate ? Developer Agreement ? Engineer's Report Un Improvement Petition <br /> ? SDC Budget Worksheet Engineering Agreement ? Engineering Service Work Request <br /> ? City Engineer's Initiating Order ®Public Improvement Permit Application ? Map <br /> i <br /> ? Request far Scoping Meeting • <br /> i <br /> <br />