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~ <br />. . . „,-~ . ^ <br />u t-~:a-;) % ~'Q2:? ~ ~ f~l <br />PROJECT AUTHORIZATION FORM <br />/ private engineer: <br />(.. <br />Service ID: <br />Project title: ~ <br />o atioi <br />Project manager / <br />Engineering <br />Public Works <br />City of Eugene <br />244 E. Broadway <br />Eugene, OR 97401 <br />(541)682-5560 <br />PROJECT SCOPE: <br />Paving: °` Il~Wdhs~ Bike lanes / paths: <br />(widlhJ <br />Concrete walks~ <br /> <br />Wastewater <br />Signal <br />ROW required <br />New building construction Planning, other <br />Remodel <br />FUNDING SOURCES: <br />City Assessments <br />Fed / State / County / FAA <br />COMMENTS / SPECIAL PROJECT INFO. / INTERDEPARTMENTAL WORK DESCRIPTION: <br />r,. <br />~ <br />~ <br />( %, fixed) <br />APPROVED: , ~ <br />Project Manager ~ Date ~ <br />Principal Engineer Date ~ ~' ~~" <br />Facilities Mana Date <br />City Engineer ~~~ Date F~l ~~-~ 1~"1- <br />~` // <br />SID / PB ~GL ~ JC ~ JE ~ <br />desciiplionJ <br />• Setback / Curbside <br />~ ~ ~ (/engthJ (wid/hJ' _ <br />Stormwater ~ • Y ~ ~ ~ dscaping <br />Street lights <br />Private Other department <br />Account code _ <br />FOR USE BY ADMINISTRATION ONLY <br />Capital Project No. ~/ ~S~ ~ ACK Ln~~°' 9c~5/ ~~l4 <br />X,c~o -c37~fsj~ <br />GL Title ~~"~"D/t~- ~~ ! t~~ <br />~ <br />Assigned by <br />Accounting by <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 ublic Improvement Permit Application ^ Map <br />^ Request for Scoping Meeting <br />~ <br />ENG 415 WHITE / Finance YELLOW / Administration File PINK / Engineering File GOLDENROD / Project Manager /ULY2004 <br />