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PROJECT AUTHORIZATION FORM <br />Service ID: <br />Project title: <br />(/o ation and work d cripfionJ <br />Project manager / contact / private engineer: <br />PB ZGL N, JC <br />PROJECT SCOPE: <br />Paving: Bike lanes / paths: <br />(widlhsJ (width) <br />Concrete walks: Setback / Curbside <br />(widlhJ ®O <br />Wastewater Stormwater Landscaping <br />Signal Street lights ROW required <br />New building construction Planning, other Remodel <br />FUNDING SOURCES: <br />City Assessments <br />Private Other department <br />Account code <br />Fed / State / County / FAA <br />COMMENTS / SPECIAL PROJECT INFO. / INTERDEPARTMENTAL WORK DESCRIPTION: <br />( %, fixed) <br />APPROVED: <br />1 26 �t Z <br />Project Manager �' �"'-"` Date <br />Principal Engineer Date �°- <br />Facilities Manager Date <br />City Engineer Date <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 <br />❑ SDC Budget Worksheet <br />❑ City Engineer's Initiating Order <br />❑ Request for Scoping Meeting <br />ENG 415 WHITE / Finance <br />❑ Developer Agreement El Engineer's Report On Improvement Petition <br />gineering Agreement <br />El Service Work Request <br />Public Improvement Permit Application ❑ Map <br />YELLOW/ Administration File PINK/ Engineering File GOLDENROD/ Project Manager JUL Y2004 <br />