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PROJECT AUTHORIZATION FORM <br />Engineering <br />Public Works <br />Service ID: 4 <br />Project title: _ 0 d"A `="M ~ <br />(location and work desMIPtion) <br />City of Eugene <br />244 E. Broadway <br />SID PB GL <br />JC <br />( <br />JE/ <br />Eugene, OR 97401 <br />541) 682-5560 <br />Project manager/ contact/ private engineer: M "+A- <br />PROJECT PROJECT SCOPE: <br />Paving: s Y11~1~~~ Bike lanes / paths: <br />(widths) (width) <br />Concrete walks: <br />(length) <br />Wastewater <br />Signal <br />(width) <br />Setback / Curbside <br />Landscaping <br />ROW required <br />New building construction Planning, other Remodel <br />FUNDING SOURCES: <br />City X- Assessments Private <br />Fed / State / County / FAA <br />COMMENTS / SPECIAL PROJECT INFO. / INTERDEPARTMENTAL WORK DESCRIPTION: <br />a . , _ r _ a, r _ n 4 _ <br />( fixed) <br />APPROVED: <br />Project Manager_ <br />Principal Engineer <br />Facilities Manager <br />City Engineer L <br />Stormwater <br />Street lights <br />Other department <br />Account code - <br />Date iI ZI/ <br />Date l~ <br />Date <br />Date FOR USE BY ADMINISTRATION ONLY <br />Capital Project No. QA ACK4~1 <br />GL Title <br />Assigned by <br />Accounting by <br />Date V-1, //-P <br />Date <br />ATTACHMENTS: <br />Budget Estimate ❑ Developer Agreement ❑ Engineer's Report On Improvement Petition <br />n SDC Budget Worksheet ❑ Engineering Agreement ❑ Engineering Service Work Request <br />❑ City Engineer's Initiating Order ❑ Public Improvement Permit Application A Map <br />❑ Request for Scoping Meeting <br />ENG 415 WHITE/Finance YELLOW/ Administration File PINK/ Engineering File GOLDENROD/ Project Manager ✓ULY2004 <br />