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40RIZATION FORM <br />Engineering <br />Public Works <br />City of Eugene <br />244 E. Broadway <br />3 Eugene, OR 97401 <br />Service ID: SID_ PB _ GL - JC _ JE _ (541) 682-5560 <br />-g Pr - <br />Project title: Dt i L Y\d. <br />(location and work desa' ton) <br />fe 4-re, PoJ <br />Project mana / contact / private engineer: C' U121d <br />PROJECT SCOPE: <br />Paving: (widths) Bike lanes / paths: <br />(width) <br />Concrete walks: Setback / Curbside <br />(length) (width) <br />Sanitary sewer Storm sewer Landscaping <br />Signal Street lights ROW required <br />New building construction Planning, other Remodel <br />FUNDING SOURCES: <br />city W M E S3 G Assessments Private <br />Fed / State / County / FAA <br />COMMENTS / SPECIAL PROJECT INFO. / 1 <br />7"],.-4 11 .mil- 1 < 4-o <br />ARTMENTAL WORK DESCRIPTION: <br />( fixed) <br />APPROVED: <br />Pro' ct Managger Date <br />Stvh'an r !''f zdpla <br />Date <br />Facilities Manager Date <br />er ;e eext5~11*' Date <br />`t r"AA- <br />FOR USE BY ADMINISTRATION ONLY <br />Capital Project No. ACK <br />GL Title <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 />❑ File Request Form <br />Other department <br />Account code _ <br />ENG 415 WHITE/Finance YELLOW/ Administration File PINK/ Engineering File GOLDENROD/ Project Manager JANUARY 2000 <br />