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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 />Service ID: ) 000 3 6 SID www. <br />FAX <br />PB GL JC JE ww. gene -. gov /parks <br />Project Title: 9!4 Z -r2 &- WORle 1 A1,4 L 4R r- <br />(location and work description) <br />Project Manager /Contact/Private Engineer: 1Z YAnJ � -, I 8- 9 , 'J-014N e.. <br />PROJECT SCOPE: <br />Paving: Bike la s aths: <br />Concvtlks: ( width s) Setb k/Cur ide wt t <br />engt wi t <br />water FIVreet m ater Lan scaping Wast Signal lig W required <br />New building construction Planning, Other Remodel <br />FUNDING URCES: <br />City F Assessments <br />Account Code � �/ " - 35 <br />Fed / State / Count / FAA <br />COMMENTS / SPECIAL PROJECT INFO. / INTERDEPARTMENTAL WORK DESCRIPTION: <br />rO k COWL" kAe I 7V .ADX)Re�U #A - /7Z6;::' ISS f5; /n6 <br />APPROVED: <br />Project Manager:. <br />Section Manager: <br />Financial Analyst: <br />Division Manager: <br />Date: <br />5-13-12- <br />Dater (` <br />Date: <br />Date: ,:3 a Z, <br />FOR USE BY ADMINISTRATION ONLY <br />Capital Project No. 902 5 3 G ACK <br />GL Title re-0, 1 <br />Assigned by: Date: 0 11: 9 0 <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 />Private Other Department <br />PWWPOS 100 WHITE/Finance YELLOW /PW Administration File PINK/Division File GOLDENROD /Project Manager July 2006 <br />