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PRCWT AUTHORIZATION FORM <br />0 <br />Public Works <br />Maintenance & <br />Parks and Open Space <br />Service ID: l o ooo Ll <br />Project Title: W M 9 I <br />(location and Wrk di <br />GL_ <br /> <br />SID PB <br />JC JE <br />City of Eugene <br />1820 Roosevelt Boulevard <br />Eugene, Oregon 97402 <br />(541) 682-4800 <br />(541) 682-4882 FAX <br />www.eugene-or.gov/parks <br />PROJECT SCOPE: <br />Paving: Bike lanes/paths: <br />w s (width) <br />Concrete walks: Setback/Curbside <br />(795517T- <br />Wastewater Stormwater Landscaping <br />Signal Street lights ROW required <br />New building construction Planning, Other Wd,*'I"1&J Remodel <br />FUNDING SOURCES: <br />City A 6 5 ~ ~ Assessments <br />Account Code <br />Fed / State / Count / FAA <br />COMMENTS / SPECIAL PROJECT INFO. / INTE <br />'n.c a a r,1 it 16 Cb n i <br />AL WORK DESSCRIP/TION: <br />A.-J 11, ld n 6)A <br />fixed) <br />APPROVED: <br />Project Manager: Date: 1~ -1 s - J U <br />Section Manager: Date: 2- L ~j • ~'~~G <br />Financial Analyst: <br />of 0 JP* L Date: -L Division Manager: Date: DZZ~2 <br />Capital Project No <br />GL Title <br />Assigned by: - <br />Accounting by: _ <br />Date: <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 />PWM/POS 100 WHITE/Finance YELLOW/PW Administration File PINK/Division File GOLDENROD/Project Manager July 2006 <br />Private Other Department <br />FOR USE BY ADMINISTRATION ONLY <br />ACK <br />