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R J C AUTHORIZATION FORM <br />Engineering <br />Public Works- <br />Service ID: <br />Project title: <br />(location and work descnotion) <br />City of Eugene <br />244 E. Broadway <br />Eugene, OR 97401 <br />(541) 682-5560 <br />SID_ PB _ GL _ JC _ JE - <br />Project manager / contact / private engineer: ?2-01SIN 0 S-ri1 e' x <br />PROJECT SCOPE: <br />Paving: <br />(widths) <br />Concrete walks: <br />(length) (width) <br />Sanitary sewer Storm sewer <br />Signal Street lights <br />New building construction Planning, other <br />FUNDING SOURCES: <br />City Assessments Private <br />Bike lanes / paths: <br />(width) <br />Setback / Curbside <br />Landscaping /Ar <br />ROW required <br />Remodel <br />Other department <br />Account code <br />Fed / State / County / FAA <br />COMMENTS / SPECIAL PROJECT INFO. / INTERDEPARTMENTAL WORK DESCRIPTION: fixed) <br />T f'Of~~~ ~!<<~A1/mom --/-~a ~r_ i+~► k--.....,....~ . - - - - - <br />/ <br />APPROVED: <br />Project Manager Date <br />Principal Engine 4 Date -~A <br />D <br />~aeiliti4e <br />J Date ti zs-h? <br />Date <br />FOR USE BY ADMINISTRATION ONLY <br />Capital Project No. ACK <br />GL Title <br />Assigned by <br />Accounting by <br />Date <br />Date <br />El Developer Agreement [I Engineer's Report On Improvement Petition <br />❑ SDC Budget Worksheet El Engineering Agreement El Engineering Service Work Request <br />❑ City Engineer's Initiating Order ❑ Public Improvement Permit Application 11 Map <br />❑ File Request Form <br />A7ACHMENTS: <br />Budget Estimate <br />ENG 415 WHITE/Finance YELLOW/ Administration File PINK/ Engineering File GOLDENROD/ Project Manager <br />JANUARY 2000 <br />