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Public Works <br />Maintenance & <br />PROJECT AUTHORIZATION FORM Parks and Open Space <br />City of Eugene <br />1820 Roosevelt Boulevard <br />Eugene, Oregon 97402 <br />(541) 682-4800 <br />(541) 682-4882 FAX <br />Service ID: SID PB GL JC JE www.eugene-or.gov/parks <br />Project Title: l"w L~fSI <br />(location and work description) <br />Project Manager/Contact/Private Engineer: <br />PROJECT SCOPE: <br />Paving: (Widths) <br />Concrete walks: <br />engt " <br />Wastewater Stormwater <br />Signal Street lights -nom <br />New building construction Planning, Other ( Z~1 Yt1! - <br />in <br />APPROVED: <br />Project Manager: <br />Section <br />Financial Analyst: <br />Division Manager: <br />FOR <br />Capital Project No.-RA/ - <br />GL Title <br />Assigned <br />Accountir <br />ATTACHMENTS: <br />❑ Budget Estimate <br />❑ SDC Budget Worksheet <br />❑ City Engineer's Initiating Order <br />❑ Request for Scoping Meeting <br />PWM/POS 100 WHITE/Finance <br />Bike lanes/paths: <br />(width) <br />Setback/Curbside <br />Landscaping <br />ROW required <br />Remodel <br />Date: <br />Date: a <br />Date: 1121 o19~d 7 <br />Date: <br />❑ Developer Agreement ❑ Engineer's Report on improvement Petition <br />❑ Engineering Agreement ❑ Engineering Service Work Request <br />❑ Public Improvement Permit Application ❑ Map <br />YELLOW/PW Administration File PINK/Division File GOLDENROD/Project Manager July 2006 <br />USE BY ADMINISTRATION ONLY <br />ACK <br />F414 IING SOURCES: <br />City 0 P Assessments Private Other Department <br />Account Code -3 o'2 9 3 35 4 / 735 Y X )CgAk 607S501.01 41-& + <br />Fed / State / Count / FAA fixed) <br />nrn..Racurrc i cocr im Pan.iFrT INFO. / INTERDEPARTMENTAL WORK DESCRIPTION: <br />