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PROJECT AUTHORIZATION FORM <br />SID N A PB ✓ GL JC N/A <br />Service ID: No GJN Issued <br />Project Title: d <br />awadon end work deso <br />Project Manager/Contact/Private Engineer: <br />PROJECT SCOPE: <br />Paving: Bike lanes/paths: <br />Concrete walks: s Setback/Curbside (width) <br />en a <br />Wastewater Stormwater Landscaping <br />Signal Street lights ROW required <br />New building construction Planning, Other Remodel <br />FUNDING SOURCES: <br />CIry-~ U <br />Account Code <br />Fed / State/ Count / FAA <br />Should be p ct number <br />Assessments Private <br />2-M I ° '1 If; ° to 117 C) Q - C) -1 <br />fixed) <br />vl-_ <br />APPROVED: <br />Project Manager: Date: <br />I <br />Section Manager: Date:.-4 • 7 DJ- <br />Financial Analyst: Date: -z h'5-1 z)!9 <br />Division Manager: Date: <br />ilb'(0(:~ FOR USE BY ADmrNISTRAT,ION ONLY <br />Capital Project No. 995542 ACK 311-933-5- <br />GL Title POR Altnn Raker LiphtinQ Renov <br />Assigned by: APPROVED _ - Date: <br />By Tammy Smith at 9.•17 am, Feb'23,-20,09 <br />Accounting by: Date: <br />ATTACHMENTS: <br />❑ Budget Estimate <br />Q.,SDC,Budget Worksheet <br />O Cityfngineees Initiating Order <br />❑ Request for Scoping Meeting <br />PWWPOS 100 WHITE/Finance <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 Administtation File PINK/Division File <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 />(541) 682-4882 FAX <br />JE BJE 65531 <br />1 <br />www.eugene-or.gov/parks <br />Manager July 2006.` <br />