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Public Works <br /> Maintenance & <br /> PROJECT AUTHORIZATION FORM Parks and Open Space <br /> /1 ;City of Eugene <br /> / 1820 Roosevelt Boulevard <br /> Eugene, Oregon 97402 <br /> (541) 682-4800 <br /> ~ (541) 682-4882 FAX <br /> Service ID: G--g~ SID PB GL JC JE ~ www.eugene-or.gov/parks <br /> Project Title: <br /> (location and work description) <br /> Project Manager/Contact/Private Engineer: !r ~/I <br /> PROJECT SCOPE: <br /> Paving: Bike lanes/paths: <br /> wits wit <br /> Concrete walks: Setback/Curbside <br /> ent wit <br /> 9 <br /> Wastewater Stormwater Landscaping <br /> Signal Street lights ROW required <br /> New building construction Planning, Other Remodel <br /> FUNDING SOURCES: ~ f® ~ ~L--- <br /> City a Assessments Private Other Department ~2''Z'--- <br /> <br /> Account Code <br /> Fed /State /Count /FAA fixed) <br /> COMMENTS /SPECIAL PROJECT INFO. /INTERDEPARTMENTAL WORK DESCRIPTION: <br /> ~ ~ ~ <br /> r <br /> i' ` <br /> APPROVED: <br /> ~ <br /> Project Manager: Date: <br /> ~ <br /> Section Manager: Date: ~ / <br /> Financial Analyst: Date: ~ ~ '3 ! D~ <br /> Division Manager: Date: 3®~ ~ <br /> FOR USE BY ADMINISTRATION ONLY <br /> Capital Project No. ACK ~ <br /> GL Title <br /> r. <br /> Assigne y: Date: 3 `~f <br /> Accounti Date: <br /> A ACHMENTS: <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 /> PWM/POS 100 WHITE/Finance YELLOW/PW Administration File PINK/Division File GOLDENROD/Project Manager July 2006 <br /> <br />