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PROJECT AUTHORIZATION FORM <br />Public Works <br />Maintenance & <br />Parks and Open Space <br />Service ID: <br />Project Title: <br />(location and work description) <br />City of Eugene <br />1820 Roosevelt Boulevard <br />Eugene, Oregon 97402 <br />(541) 682-4800 <br />(541) 682-4882 FAX <br />SID PB GL JC - JE www.eugene-or.gov/parks <br />IBS A:4l21S l t0 t-~ %-VN M l pl tz <br />Project Manager/Contact/Private Engineer: INf i V.{ri l5S <br />PROJECT SCOPE: >Qvltsv-wTJ 0P(-A- <br />Paving: <br />wi s <br />Concrete walks: <br />eng t <br />Wastewater Stormwater <br />Signal <br />New building construction <br />Street li hts <br />tanning ther <br />1lmi <br />N /p5r <br />Bike lanes/paths: <br />(width) <br />Setback/Curbside <br />qui _ <br />Remodelp <br />FUNDING SOS <br />City E~Dgx;, Assessments Private Other Department <br />Account Code 3 3 5- q-7S 15 -4- <br />Fed / State / Count / FAA fixed) <br />COMMENTS / SPECIAL PROJECT INFO. / INTERDEPARTMENTAL WORK DESCRIPTION: <br />'Fo1vA"Py IS a TO-0 1tiTcr/z~ vN Ill - NOT p'Dy &-l.o P,, T <br />v I ) S c in -FT uut I' r►y„ i`Jo r 4-(.u Fr-Ua ,r> cj <br />P 44 S ZED K a. oel U-,k yy► , j .y i <br />Mo(ee'tc,4X1i AJ IS 110-OrL-d I'A 4A4U#'l D 0U,,r C zr Qpp-r,:)x -~2Oc) hrS cif ~aNhL(VJ <br />1 c:e` K -J <br />APPROVED: <br />Project Manager:.( 2242YZ- . C~, JAe ~ - Date: c3 I i>7 <br />Section Manager: Date: <br />Financial Analyst: Date: <br />Division Manager: Date: <br />FOR USE BY ADMINISTRATION ONLY <br />Capital Project No. ACK <br />GL Title <br />Assigned by: <br />Accounting by: - <br />ATTACHMENTS: <br />Date: <br />Date: <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 />PWWPOS 100 WHITE/Finance YELLOW/PW Administration File PINK/Division File GOLDENROD/Project Manager July 2006 <br />