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PROJECT AUTHORIZATION FORM <br />Publ(c Works <br />htalntenance and <br />Parks & Open Space Divisions <br />Cityo1 Eugene <br />1829RooseveltBlvd. <br />Eugene, Oregon 97402 <br />(541)682-4800 <br />(541)682.4882 FAX <br />y491y.eunen •or.aov <br />Service ID: 100050 SID PB_ GL_ JC_ JE <br />Project Title: Existing Playground Rehab <br />(location and work description) <br />Project Manager/Contact/Private Engineer: Kevin Finney <br />FUNDING SOURCES: <br />City x Assessments Private Other Department <br />Account Code 311-9335-xxxxx-985222 <br />- - <br />Fed/State/Count/FAA (%,FIXED) <br />COMMENTS/SPECIAL PROJECT INFO./INTERDEPARTMENTAL WORK DESCRIPTION: <br />This is an A6 capital project. We need to charge staff time against this so are requesting a GJN. <br />APPROVED: <br />Project Manager: <br />Date: <br />Section Manager: <br />Date: <br />Financial Analyst: <br />Date: <br />Division Manager: <br />• L. Date: <br />FOR USE BY ADMINISTRATION ONLY <br />pital Project No. ACK 3 H cj 3 3~~ v,<< <br />Title <br />signed by: Date: <br />:ounting by: Date: <br />A I 1 At-HrVIUM I S: <br />I <br />