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PROJECT AUTHORIZATION FORM <br />Engineering <br />Public Works <br />City of Eugene <br />244 E. Broadway <br />2 ugene, OR 401 <br />(541) 682-5560 <br />Service ID: ~70 SID PB GL JC . JE <br />t~t <br />Project title: /-Iazn&i <br />(iooalion and work desciiplion) <br />Project manager / contact / private engineer: l e c Co v S 3' <br />PROJECT SCOPE: <br />Paving: <br />Concrete walks: <br />(ienglhJ <br />Wastewater <br />Setback / Curbside <br />(widlhJ <br />Stormwater~ 11t;~~~-C~;yn~~ Landscaping <br />Signal Street lights ROW required <br />New building construction Planning, other Remodel <br />FUNDING SOURCES: <br />City toir, - W T 53 i Assessments Private <br />Fed / State / County / FAA <br />COMMENTS / SPECIAL PROJECT INFO. / INTERDEPARTMENTAL <br />Other department <br />Accountcode <br />fixed) <br />K DESCRIPTION: <br />1 r L-V V L, "FC L.24eLn ( I 'n. i E- l0 1Q I ! I t a.t v~ IACA- r- I 0 tr v-\ <br />6LtA f~~1 t 0ti a~ ~`ia tie c(~o <br />APPROVED: <br />Project Manager /,j Date t (~9 <br />f ~ <br />Principal Engineer Date <br />Facilities Manager Date <br />City Engineer Date ,4 ° <br />Capital Project No <br />GL Title <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 ❑ Public Improvement Permit Application ❑ Map <br />❑ Request for Scoping Meeting <br />FOR <br />G,t6 8 It, <br />Bike lanes / paths: <br />(widlhJ <br />USE BY AD <br />ACK -f201- MINISTRATION ONLY <br />ENG 415 WHITE/Finance YELLOW/ Administration File PINK/ Engineering File GOLDENROD/ Project Manager ✓ULY2004 <br />