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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 />(541) 682 -4882 FAX <br />Service ID: 10006 3 SID PB GL JC JE www.eugene - or.gov /parks <br />Project Title: L I ( q eti e S' T.Pa rv, Dona i'6n S <br />(location and work description) <br />P roject Manager /Contact/Private Engineer: 1aCki -A VW I CAI <br />PROJECT SCOPE: <br />Paving: <br />wi is <br />Concrete walks: <br />(length) <br />Wastewater <br />Signal <br />New building construction <br />( widt h) <br />Stormwater <br />Street lights <br />Planning, Other <br />Bike lanes /paths: <br />(width) <br />Setback/Curbside <br />Landscaping <br />ROW required <br />Remodel <br />FUNDING SOURCES: <br />City Assessments Private Other Department <br />Account Code 0�7 9335 - L C 7 a 6 a- ✓bt I.�SL C� c��, <br />Fed / State / Count / FAA ( %, fixed; <br />COMMENTS / SPECIAL PROJECT INFO. / INTERDEPARTMENTAL WORK DESCRIPTION: <br />q)r1\l1 bc,.n N ��fQGY� 2C�Vh <br />APPROVED: <br />Project Manager: Date: Cam• �• �I <br />r✓ <br />Section Manager: Date: 2/ z/ <br />Financial Analyst: Date: <br />Division Manager: Date: , '0 <br />FOR USE BY ADMINISTRATION ONLY <br />Capital Project No. ACK <br />GL Title <br />Assigned by: Date: <br />Accounting by: 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 />PWWPOS 100 WHITE/Finance YELLOW /PW Administration File PINK/Division File GOLDENROD /Project Manager July 2006 <br />