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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 />Service ID: -1 3 SID V PB GL4- JC / JE (541) 682-5560 <br />PP 04011 si o m e, VN Q l T3 <br />Project title: <br />(location and work description) <br />Project manager / contact / private engineer: =A,a <br />PROJECT SCOPE: <br />Paving: <br />Concrete walks: <br />(langth) <br />Wastewater <br />Signal <br />Bike lanes / paths: <br />(width) <br />Setback / Curbside <br />(width) <br />Stormwaterv 3~4S 171: jStALandscaping <br />Street lights <br />New building construction Planning, other <br />FUNDING SQURCES: <br />City Assessments <br />Private <br />ROW required <br />Remodel <br />Other department <br />Account code _ <br />rc <br />APPROVED: <br />Project Manager - Date p <br />Principal Engineer LL-` M, Date 711:6 <br />.facilities Manager _ ✓ Date <br />City Engineer _ Date <br />FOR USE <br />Capital Project No. - n <br />GL Title .2 6 /l <br />Assigned by <br />Accounting by <br />Date 111,3111 <br />- <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 X Map <br />❑ Request for Scoping Meeting <br />ENG 415 WHITE/Finance YELLOW/ Administration File PINK/ Engineering File GOLDENROD/ Project Manager ✓ULY2004 <br />BY ADMINISTRATION ONLY <br />19- <br />Fed / State / County / FAA fixed) <br />Cn1A11AFNTC / CP1:f`1A1 PRn.WrT INFn / INTFRnFPARTMFNTAL WnRK nFSCRIPTInNe <br />