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PROJECT AUTHORIZATION FORM <br />Service ID:- 1~ ( / 1, <br />Project title: rl /V Ja°`7 Y~Z d V <br />(location and w01k dese-0110n) <br />Project manager / contact / private engineer: <br />Engineering <br />Public Works <br />City of Eugene <br />244 E. Broadway <br />Eugene, OR 97401 <br />SID.P_B.-_~~~ +~JC _ JE _ <br />PROJECT SCOPE: z1 / <br />Paving: (Wi t S) Bike lanes/ paths: <br />(w/arhJ <br />Concrete walks: Setback / Curbside <br />(/englhJ (wrdlhJ <br />Wastewater Stormwater <br />Signal Street lights <br />New building construction Planning, other <br />FUNDING SOURCES: <br />City Assessments Private <br />Fed / State / County / FAA <br />Landscaping <br />ROW required <br />Remodel <br />Other department <br />Account code _ <br />( fixed) <br />COMMENTS / SPECIAL PROJECT INFO. / INTERDEPARTMENTAL WORK DESCRIPTION: <br />e..P <br />APPROVED: 1,2 <br />Project Manager ✓1 - vt et , Date r ° <br />Principal Engineer d) I Date . <br />Facilities Manage Date <br />City Engineer Date <br />FOR USE BY ADMINISTRATION ONLY <br />Capital Project No. '37 q7 It ACK ~ SI- g3SP _ b~ XX <br />GL Title <br />Assigned by <br />Accounting by <br />Date a 6~ <br />Date <br />ATTACHMENTS: <br />❑ Budget Estimate ❑ Developer Agreement ❑ Engineer's Report On Improvement Petition <br />❑ SDC Budget Worksheet R Engineering Agreement ❑ Engineering Service Work Request <br />❑ City Engineer's Initiating Order C14ublic Improvement Permit Application ❑ Map <br />❑ Request for Scoping Meeting <br />ENG 415 WHITE/Finance YELLOW/ Administration File PINK! Engineering File GOLDENROD/ Project Manager .1U Y2004 <br />