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~RO~G`i 1 /4U. 1 H~R~ZATlON FORM Engineering <br />Public Works <br />City of Eugene <br />~y.,~~ 244 E. Broadway <br />~~~~~ugene, OR 97401 <br />Service ID: ~~~ SID "+J PB ~GL ~ ~E ~ (541) 682-5560 <br />Project title: ~~''f I^^ 1'-~V~ab ' ~~u e ~ ~ T3luc~ <br />/location and work description) M <br />Project manager/contact /private engineer: 1 `A ~ ~~ ~-i r~ ;~ e s <br />PROJECT SCOPE: <br />Paving: Bike lanes /paths: <br />(widlhsJ (widlhJ <br />Concrete walks: Setback /Curbside <br />(/engthf wid! <br />Wastewater Stormwater •~- E~• ~ ~`tandscaping <br />Signal Street lights ROW required <br />New building construction Planning, other Remodel <br />FUNDING SOURCES: <br />City X Assessments Private <br />Fed /State /County /FAA _ <br />COMMENTS /SPECIAL PRO) <br />~Tt. _ _ ,. 1 ~. _. <br />INFO. /INTERDEPARTMENTAL <br />f esna~ ,r- ~,.,1 r- ~.~ Ia-e <br />Other department <br />Account code <br />n (%,,~f}i~xed) <br />K4DES~RICTL N_ . _I '__ ~ L..... I _ <br />_~~ ~ e d . r...~a-r rc a c;o ~~ r~ r ~ .er <br />1~ •., ~~ ~ ~..:o. Sa-..~ c~ ;~,~ G-c~ ,~ "l ~ a Cyr.. ~z.~- r r. <br />APPROVED: <br />Project Manager_ <br />Principal Engineer <br />Facilities Manager <br />City Enginee~ <br />Date ~ - <br />Date <br />Date <br />Date ~~1~ ~~ <br />FOR USE BY ADMINISTRATION ONLY <br />Capital Project No. ~ ~~~~ ACK `, ~ ~ ~ ~ ~Z_ ~~~~ ~ ~~~~~ <br />GL Title S. 6t'~ 1 ~ Sr?~,~, ~ ~` <br />Assigned by Date ~ <br />Accounting by Date - ~ <br />ATTACHMENTS: <br />1 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 />ENG 415 WHITE /Finance YELLOW /Administration File PINK /Engineering File GOLDENROD /Project Manager JUL Y2004 <br />