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1►� <br />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: / oU Da SID �^ PB GL JC JE www.eugene- or.gov /parks <br />Project Title: C a na & eAn A( I-n S k W 04 <br />(location and work description) <br />Project Manage ontact/Private Engineer: & r1—c— IJ o (d <br />PROJECT SCOPE: <br />Paving: Bike lanes /paths: <br />Concrete walks: (widths) Setback/Curbside (wid <br />en gM) (widt <br />Wastewater Stormwater Landscaping <br />Signal Street lights ROW required <br />New building construction Planning, Other V Remodel <br />FUNDING SOURCES: <br />City Assessments Private Other Department <br />Account Code tt <br />Fed State / Count / FAA Qb % �ro w^ N 17 A A 9-r.,r. A-l- ( %, fixed) <br />COMMENTS / SPECIAL PROJECT INFO. / INTERDEPARTMENTAL WORK DESCRIPTION: <br />APPROVED: <br />Project Manager: / —` Date: / <br />Section Manager: / Date: <br />Financial Analyst: Date: / /31/ /Z <br />Division Manager: Date: — 3/ —/'z <br />Capital Project <br />GL Title <br />Assigned by: <br />Accounting by: <br />FOR USE BY ADMINISTRATION ONLY <br />ACK <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 />