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PROJECT AUTHORIZATION FORM Engineering <br />Public Works <br />City of Eugene <br />244 E. Broadway <br />J Gy Eugene, OR 97401 <br />4 A! SID!' PB /GL JC Y JE (541) 682-5560 <br />Service ID: <br />Project title: P s'.-"-! -PA 4 r~~ v~~ Or- <br />(iocat/on and work description) <br />Concrete walks: <br />(length) <br />Wastewater <br />Signal <br />Stormwater <br />Street lights <br />(width) <br />New building construction Planning, other Remodel <br />FUNDING SOURCES: <br />City X - - Assessments Private <br />Fed / State / County / FAA <br />/ SPECIAL PROJECT INFO. / INTERDEPARTMENTAL WORK DESCRI <br />fixed) <br /> <br />~iIE N ANI <br />APPROVED: /,/1A <br />Project Manager_ <br />Principal Engineer <br />Facilities Manager <br />City Engineer <br />Setback / Curbside <br />Landscaping <br />ROW required <br />Other department <br />Account code - <br />Date ~I If --C-V-~( <br />Date- <br />Date - - <br />Date, <br />FOR USE BY ADMINISTRATION ONLY <br />Capital Project No. ~6 ACK r / <br />GL Title <br />Assigned by <br />Accounting by <br />Date <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 K Map <br />❑ Request for Scoping Meeting <br />ENG 415 WHITE/Finance YELLOW/ Administration File PINK/ Engineering File GOLDENROD/ Project Manager ✓UL Y2004 <br />PROJECT SCOPE: <br />Paving m 1sc ~(wids) Bike lanes / paths: <br />(WIdrh> <br />