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PROJECT AUTHORIZATION FORM <br />Engineering <br />Public Works <br />City of Eugene <br />244 E. Broadway <br />Z Eugene, -597401 <br />Service ID: ~ (541) 682-5560 <br />SIDB GL JC VJE <br />Project title: Pam W~ nn <br />4'r nm 5'h V e, io 7ila Nye, <br />(location and work desciiarion) <br />Project manager / contact / private engineer: 4(3 ® [ a e, j <br />PROJECT SCOPE: <br />Paving: 6S~ 1 A *~S Bike lanes /paths: <br />(widths) (width) <br />Concrete walks: <br />(iengp) <br />Wastewater <br />Signal <br />New building construction <br />FUNDING SOURCES: <br />City X Assessments <br />Fed / State / County / FAA <br />Setback / Curbside <br />Landscaping <br />ROW required <br />Remodel <br />Other department <br />Account code <br />fixed) <br />APPROVED: <br />Project Manager_ <br />Principal Engineer <br />Facilities Manager <br />City Engineer ci <br />Date <br />Date 1 r® <br />Date <br />Date <br />FOR USE BY ADMINISTRATION ONLY <br />Capital Project No. 7J / ACK~ <br />GL Title 7,6z?l I-J, 7"-A4e <br />Assigned <br />Accounting by <br />Private <br />(widthf <br />Stormwater <br />Street lights <br />Planning, other <br />Date <br />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 X Map <br />❑ Request for Scoping Meeting <br />ENG 415 WHITE/Finance YELLOW/ Administration File PINK/ Engineering File GOLDENROD/ Project Manager ✓UL Y2004 <br />COMMENTS / SPECIAL PROJECT INFO. / INTERDEPARTMENTAL WORK DESCRIPTION: <br />