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PROJECT AUTHORIZATION FORM <br />Service ID:- Li <br />Project title: <br />Monalion and work desawtion) <br />Engineering <br />Public Works <br />City of Eugene <br />244 E. Broadway <br />X Eugene, OR 97401 <br />SID PB GL JC E(541) 682-5560 <br />Project manager / contact / private engineer: <br />PROJECT SCOPE: <br />Paving: <br />(wldrhsJ <br />Concrete walks: Bike lanes/ paths: <br />(w/d1hJ <br />(/englhf (w;d Setback / Curbside <br />Wastewater Stormwater <br />Landscaping <br />Signal Street lights <br />ROW required <br />New building construction Planning, other <br />Remodel <br />FUNDING SOURCES: <br />City Assessments <br />{ Private Other department <br />Fed / State / County / FAA Account code <br />COMMENTS / SPECIAL PROJECT INFO. / INTERDEPARTMENTAL WORK DESCRIPTION: fixed) <br />rim 0,1 <br />APPROVED: <br />Project Manager <br />Principal Engineer"Date <br />a Date _1.=2XI -6 <br />' <br />Facilities Manager ~ <br />City Engineer. Date <br />Date <br />n, FOR USE BY ADMINISTRATION ONLY <br />i Capital Project No. =/C~.S ACK 531 3, - <br />9 <br />GL Title --P QU1 0 4-6r <br />Assigned by Date Accounting by <br />Date <br />ATTACHMENTS: <br />Budget Estimate ❑ Developer Agreement <br />SDC Budget Worksheet ❑ Engineering Agreement ❑ Engineer's Report On Improvement Petition <br />❑ City Engineer's Initiating Order ❑ Public Improvement Permit Application ❑ M pineering Service Work Request <br />❑ Request for Scoping Meeting <br />ENG 415 WHITE/Finance YELLOW/ Administration File PINK/ Engineering File GOLDENROD/ Project Manager ✓UL Y2004 <br />