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PROJECT AUTHORIZATION FORM <br />Service ID: 4(0-73 SID ~V PB q - <br />Project title: Y-C 10 PC 4- l I e 12 r r~s ~ FIVJIA 92.14^2 <br />(location and work description) A <br />Engineering <br />Public Works <br />City of Eugene <br />244 E. Broadway <br />Eugene, OR 97401 <br />016 a JC JE (541) 682-5560 <br />~ <br />Project manager / contact / private engineer: ieo i l!• r WJ16 - <br />PROJECT SCOPE: <br />Paving: 0Wr 14 y1 rPK i8 `fete id . <br />(widfhsJ <br />Concrete walks: No <br />(length) <br />Wastewater 410 <br />Signal <br />New building construction Alo <br />Bike lanes / paths: L3 <br />(widlh) <br />Setback / Curbside <br />Landscaping <br />ROW required b <br />Remodel A h <br />(width) <br />Stormwater <br />Street lights <br />Planning, other A/ D <br />FUNDING SOURCES: <br />City Assessments Private <br />Fed / State / County / FAA <br />Other department <br />Accountcode <br />COMMENTS / SPECIAL PROJECT INFO. / INTERDEPARTMENTAL WORK DESCRIPTION: <br />( fixed) <br />APPROVED: <br />Project M <br />Principal <br />Facilities Manager <br />City Engineerc~ <br />Date-4+441-1 1 <br />Date ° l-2- 42 <br />Date <br />Date C-11 <br />FOR USE BY ADMINISTRATION ONLY <br />Capital Project No. 31-7 01:7 ACK `Q3 1r22ClG~C}?C'>L " i 7n~I <br />GL Title <br />Assigned by <br />Accounting by <br />Date 46 <br />Date <br />ATTACHMENTS: <br />X 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 />