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PROJECT AUTHORIZATION FORM <br />Public Works <br />Maintenance & <br />Parks and Open Space <br />City of Eugene <br />1820 Roosevelt Boulevard <br />Eugene, Oregon 97402 <br />(541) 682-4800 <br />4H (541) 682-4882 FAX <br />Service ID: I I SID PB GL JC JE www.eugene-or.gov/parks <br />Project Title: LS G U, t £ ITYt3h) ~l~cr1►J N a <br />(location and work description) <br />Project Manager/Contact/Private Engineer: ItiS -nz*-- <br />PROJECT SCOPE: <br />Paving: <br />(widths) <br />Concrete walks: <br />(length) <br />Wastewater <br />Signal <br />New building construction <br />Bike lanes/paths: <br />(width) <br />Setback/Curbside <br />(width) <br />Stormwater <br />Street lights _ <br />Planning, they <br />Landscaping _ <br />ROW required <br />Remodel <br />FUNDING SOURCES: <br />CityTOPb ~L Qsessments Private Other Department <br />Account Code b)oZ '°XxXX~ <br />Fed / State / Count / FAA fixed) <br />COMMENTS / SPECIAL PROJECT INFO. / INTERDEPARTMENTAL WORK DESCRIPTION: <br />,znb jv R05, OnP P - 1616-50 <br />tPliVi A edh, 1 t Se -rtav*A r--2 vt \ I ► T1 -M wA G A~Y~I-mil .a.- v e^ L <br />NIAIG, <br />APPROVED: <br />Project Manager: Date: <br />Section Manager: Date: 3-1Y • 07 <br />Financial Analyst: Date: 31 lq/b <br />Division Manager: Date: 3 <br />Capital Project <br />GL Title <br />FOR USE BY ADMINISTRATION ONLY <br />ACK <br />Assigned by: Date: <br />Accounting by: <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 ❑ Map <br />❑ Request for Scoping Meeting <br />PWWPO.S 100 WHITE/Finance YELLOW/PW Administration File PINK/Division File GOLDENROD/Project Manager July 2006 <br />