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PROJECT AUTHORIZATION FORM <br />Engineering <br />Public Works <br />City of Eugene <br />244 E. Broadway <br />Eugene, OR 97401 <br />(541) 682-5560 <br />Service ID: I SID <br />Project title' <br />Project manager / contact / private engineer: <br />PB- GL_JC_ JE_ <br />lip ::r, <br />PROJECT SCOPE: / <br />Paving: ® Bike lanes / paths: <br />(width J (width) <br />Concrete walks: Setback / Curbside <br />Bg(lengthJ (width) <br />Wastewater 25 Stormwater ' S60 I K Landscaping <br />Signal Street lights ® ROW required <br />New building construction Planning, other Remodel N <br />FUNDING SOURCES: <br />City Assessments Private <br />Other department <br />Account code <br />Fed / State / County / FAA <br />COMMENTS / SPECIAL PROJECT INFO. / INTERDEPARTMENTAL WORK DESCRIPTION: <br />fixed) <br />APPROVED: <br />e <br />Project Manager Date 111 <br />~^!~"v lGeo e'er Date f~ f® <br />Principal Engineer <br />Facilities Manager Date © <br />City Engineer "t A - Date C7/ i a A D <br />3-704719 FOR USE BY ADMINISTRATION ONLY <br />Capital Project No. ACK & i" 6 -6 ° Le °~)I 2~-j ~ <br />GL Title F i"1i 14& r ~ 7~- <br />Assigned by <br />Accounting by <br />Date z 7 <br />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 ✓ULY2004 <br />