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PROJECT AUTHORIPATION FORM Engineering <br />Public Works <br />City of Eugene <br />244 E. Broadway <br />i\ Eugene, OR 97401 <br />Service ID: Ll q I (541) 682-5560 <br />SI61- PB 'K GL JC JET <br />Project title: V I D f- P-1 PA E A< <br />Qocation and work dewdp0m) <br />Project manager/ contact/ private engineer: t" i ! o p R) CH A P-D~>O NI <br />Concrete walks: <br />(length) <br />Sanitary sewer Storm sewer <br />(width) <br />Setback / Curbside <br />Landscaping <br />Signal Street lights ROW required <br />New building construction Planning, other PA R0C D t Ve Remodel <br />FUNDING SOURCES: <br />City Assessments Private Other department <br />Account code <br />Fed / State / County / FAA fixed) <br />COMMENTS / SPECIAL PROJECT INFO. / INTERDEPARTMENTAL WORK DESCRIPTION: <br />APPROVED: <br />Project Manager r` t Date 1 06 <br />Prinn'cl' aI gng n 1 Date - (2 <br />Facilities Manager_ - Date <br />2 < 3 <br />r Ey A/* ~ • Date y <br />s <br />FOR USE BY ADMINISTRATION ONLY <br />Capital Project No. rl 5 11 ACK 33 U 9'213 5 KXX v, <br />f J <br />GL Title <br />Assigned 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 />43 <br />ENG 415 WHITE/Finance YELLOW/ Administration File PINK/ Engineering File GOLDENROD/ Project Manager JANUARY 2000 <br />