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~ ~ ~ { <br /> ~ ! pR JECT A THORIZATION FORM r~ ~ Engineering <br /> V Public Works <br /> City ofEugene <br /> 244 E. Broadway <br /> Eugene, OR 97401 <br /> L~ ~ 1 . J (541 j 682-5560 I <br /> Service ID: ~ he l SID. PB " GL JC" JE <br /> Project title: ~Cr ~-h+° ~1~//--~ ~y~~~'~j~X ~~,d'1 ~ / l~~ <br /> p rian and wo descnprionJ <br /> P ojeGt manager /contact /private engineer: G~.l n_ ~ w f <br /> i <br /> ~ PROJECT SCOPE: <br /> Ptl<ving: Bike lanes /paths: <br /> (widrhsJ (widrhl <br /> Concrete walks: Setback /Curbside <br /> (/engthf /widlh~ <br /> Wastewater Stormwater Landscaping <br /> i <br /> Signal Street lights -~'r""~r ROW required i <br /> i <br /> New building construction Planning, other Remodel <br /> i <br /> ~ ~ I FWNDING SOURCES: <br /> City Assessments Private Other department <br /> Account code <br /> F~d / State J County /FAA fixed) <br /> ' } OMjVIENTS /SPECIAL PROJECT INFO. /INTERDEPARTMENTAL WORK DESCRIPTION: <br /> ~ ~ <br /> 1 ~ .Y <br /> } I <br /> ! <br /> a I <br /> .,d: , <br /> z i <br /> ~ /~PPROVED: <br /> f~roject Manager ~ ~ ~ Date ~ 2 <br /> <br /> j ~ {?rincipal Engineer Date <br /> facilities Manager Date <br /> City Engineer Date ~l ; ! ~oG <br /> <br /> I I <br /> FOR USE BY ADMINISTRATION ONLY <br /> Capital Project No. ~ r y Y / ~ "ACK t~/ ~ ~ `'f 3 ~ ~ LG~ ~ ~ ~ ~ , <br /> GL Title <br /> - ~ j4ssigned b ~ Date <br /> r4ccounting by Date <br /> `ATTACHMENTS: <br /> Budget Estimate ? Developer Agreement ? Engineer's Report.6n Improvement Petition <br /> <br /> ~ j ? SDC Budget Worksheet Ch'E`ngineering Agreement ? Engineering Service Work Request <br /> ? City Engineer's Initiating Order I~ Public Improvement Permit Application ? Map <br /> Request for Scoping Meeting ~ <br /> V <br /> ENG 475 WHITE /Finance YELLOW /Administration File PINK /Engineering File GOLDENROD /Project Manager ?UL Y2004 ~ <br /> <br />