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PROJECT AUTHORIZATION FORM <br />'-79 <br />Other department <br />Account code - <br />Service ID: I W SID PB GL JC JE t <br />Project title: 'Jf /a.' ~ 1 /i i c~ v s- 5 c V - 4 <br />(location and work desciiptionJ <br />Project manager / contact / private engineer: cr ~1 .A-) XS J c' <br />PROJECT SCOPE: <br />Paving: Bike lanes / paths: <br />(widlhsJ (widlhJ <br />Concrete walks: Setback / Curbside <br />(length) (widlhJ <br />Wastewater Stormwater Landscaping <br />Signal Street lights ROW required <br />New building construction Planning, otherfk~ ~P?r Remodel <br />FUNDING SOURCES: <br />City --'53 Assessments Private <br />Fed / State / County / FAA <br />MENTS / SPECIAL PROJECT INFO. INTERDEPARTMENTAL WORK DESCRIPTION: <br />s, r 'I" I~(75; d <br />A. ~~c> <br />APPROVED: <br />Project Manager_ <br />Principal Engineer <br />Facilities Manager <br />City Engineer <br />a, DA <br />City of Eugene <br />244 E. Broadway <br />Eugene, OR 97401 <br />^ /,t Alf / j (541) 682-5560 <br />1W Engineering <br />Public Works <br />fixed) <br />a = 42 <br />~:iG f T~ C <br />Date / A7 /0? <br />Date <br />Date <br />Date 147 <br />FOR USE BY ADMINISTRATION ONLY <br />Capital Project No.ACK 61x'- <br />GL Title <br />Assigned by Date /Oak <br />Accounting by Date <br />ATTACHMENTS: <br />❑ Budget Estimate ❑ Developer Agreement ❑ Engineer's Report On Improvement Petition <br />❑ SDC Budget Worksheet ❑ Engineering Agreement ❑ Engineering Service Work Request <br />❑ City Engineer's Initiating Order ❑ Public Improvement Permit Application ❑ Map <br />❑ Request for Scoping Meeting <br />ENG 415 WHITE/Finance YELLOW/ Administration File PINK/ Engineering File GOLDENROD/ Project Manager ✓UL Y2004 <br />