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PROJECT AUTHORIZATION FORM <br />Service ID: <br />Setback / Curbside <br />Landscaping <br />ROW required <br />Remodel <br />Project title: t U I' I I ® I-~N 1\dJl4y VIM L) H uk,- " LjA f i^ To 1 <br />(location and work description) <br />Pcontact / private engineer: ko R Lke <br />PROJECT SCOPE: <br />Paving: Bike lanes / paths: <br />(widths) (width) <br />Concrete walks: <br />(length) <br />Wastewater <br />Signal <br />(width) <br />Stormwater <br />Street lights <br />New building construction Planning, other <br />FUNDIN S URCES: <br />City Assessments Private <br />Fed / State / County / FAA <br />COMMENTS / SPECIAL PROJECT INFO. / INTERDEPARTMENTAL WORK <br />Engineering <br />Public Works <br />Other department <br />Account code <br />fixed) <br />PTION: <br />-~n k dIt) WdT cL <br />APPROVED: <br />Project Manager_ <br />Principal Engineer <br />Facilities Manager <br />City Engineer <br />Date <br />Date <br />Date <br />Date <br />FOR USE BY ADMINISTRATION ONLY > <br />Capital Project No. Rm (vo 4ACK8T,3- 337-&XxzX tPd <br />GL Title -f Vey_ (1l) 41 - eQ 61 Va <br />Assigned by Date <br />Accounting by 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 Map <br />❑ Request for Scoping Meeting <br />ENG 415 WHITE / Finance YELLOW/ Administration File PINK/ Engineering File GOLDENROD/ Project Manager ✓UL Y2004 <br />City of Eugene <br />244 E. Broadway <br />/ ~t"' ~ <br />SID z PB Z GL JC ' JE T <br />Eugene, OR 97401 <br />(541) 682-5560 <br />