PROJECT AUTHORIZATION FORM <br />Engineering <br />Public Works <br />City of Eugene <br />244 E. Broadway <br />` Eugene, 97401 <br />, ~ ~ (541) 682--5 5560 <br />Service ID: SID/ PB ✓ GL ! JC JE <br />Project title: <br /> <br />(location and work description) <br />Project manager / contact / private engineer: <br />PROJECT <br />_P,V~ 4J0,a <br />Concrete walks: <br />(length) <br />Wastewater <br />Signal <br />Stormwater <br />Street lights <br />(width) <br />New building construction Planning, other <br />Bike lanes / paths: <br />Setback / Curbside _ <br />Landscaping <br />ROW required <br />Remodel <br />FUNDING SOURCES: <br />City -Assessments Private <br />Other department <br />Account code - <br />APPROVED: <br />Project Manager Date It /Cf a <br />Principal Engineer Date 1 <br />Facilities Manager Date <br />City Engineer o tC1 Date 1111-610 <br />FOR USE BY ADMINISTRATION ONLY 2 <br />x ~'x <br />Capital Project No. ~ ~ ACK 93 1- q33, Z- (9 <br />GL Title 7 2- <br />Assigned b Date <br /> <br />Accounting by Date <br />ATTACHMENTS: <br />❑ Budget Estimate ❑ Developer Agreement ❑ Engineer's Report On Improvement Petition <br />❑ SDC Budget Worksheet ❑ Engineering Agreement ❑ XEngineering Service Work Request <br />❑ City Engineer's Initiating Order ❑ Public Improvement Permit Application Map <br />❑ Request for Scoping Meeting <br />(width) <br />ENG 415 WHITE/Finance YELLOW /Administration File PINK/ Engineering File GOLDENROD/ Project Manager ✓ULY2004 <br />Fed / State / County / FAA ( fixed) <br />COMMENTS / SPECIAL PROJECT INFO. / INTERDEPARTMENTAL WORK DESCRIPTION: <br />