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PROJECT AUTHORIZATION FORM <br />Engineering <br />Public Works <br />City of Eugene <br />244 E. Broadway <br />Eugene, OR 97401 <br />(541) 682-5560 <br />Service ID: SID- PB /GL /C JE <br />Project title: i, V fa :broM <br />(10catdwok esriplion) <br />W66 <br />Project manager/ contact/ private engineer- R O AX, A woe's <br />PROJECT SCORE: <br />Paving: mks(, W'1 A ~a' <br />~ ,5 Bike lanes / paths: <br />(widlhsl (width) <br />(width) <br />Stormwater <br />Street lights <br />Planning, other <br />Concrete walks: <br />(/englh) <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: f <br />Project Manager Date <br />Principal Engineer Date <br />Facilities Manager Date <br />City Engineer Date a - <br />(J' FOR USE BY ADMINISTRATION ONLY <br />Capital Project No. ACK ~33~~x ° ~t✓S ~~1 <br />GL Title <br />Assigned by ~IV410 -12 Date _/L v <br />Accounting by Date <br />ATTACHMENTS: <br />I Budget Estimate El Developer Agreement El 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 />Private <br />ENG 415 WHITE/Finance YELLOW/ Administration File PINK/ Engineering File GOLDENROD/ Project Manager ✓ULY2004 <br />COMMENTS / SPECIAL PROJECT INFO. / INTERDEPARTMENTAL WORK DESCRIPTION: <br />