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PROJECT AUTHORIZATION FORM <br />Public Works <br />Maintenance & <br />Parks and Open Space <br />10 OU 1 W oc K-'t'-% e o d <br />Service ID: SID PB GL <br />Project Title: DA&1 1 1ZC24-e- Keno TGr~ <br />(location and work description) <br />Project Manager/Contact/Private Engineer: <br />City of Eugene <br />1820 Roosevelt Boulevard <br />Eugene, Oregon 97402 <br />(541) 682-4800 <br />(541) 682-4882 FAX <br />JC JE www.eugene-or.gov/parks <br />c~ <br />c A=A <br />PROJECT SCOPE: <br />Paving: <br />wits <br />Concrete walks: <br />engt (width) <br />Wastewater Stormwater <br />Signal Street lights <br />New building construction Planning, Other <br />Bike lanes/paths: <br />(width) <br />Setback/Curbside <br />Landscaping <br />ROW required <br />Remodel <br />FUNDING SOURCES: <br />City 9 ALP, S E) T Assessments Private Other Department <br />Account Code _\3 • ~3 ~S ' Lp l <br />Fed / State / Count / FAA {ar yNN ['Cea,I+ fixed) <br />COMMENTS / SPECIAL PROJECT INFO. / INTERDEPARTMENTAL WORK DESCRIPTION: Q &MO ex;s-k'nir <br />2I, <br />~r <br />APPROVED: <br />Project Manager: Date: 41 ((a d <br />Section Manager: Date: 9 <br />Financial Analyst: Date: <br />V -if <br />Division Manager: l~ I U~j Date: <br />{V O'I'e- ~ ~ ~ .l9 <br />) N O N L Y <br />Capital Project No.~ <br />aJ. ,)a ~f o. ,rte U-) L- N fir <br />GL Title ~~UJ <br />Assigned by: n _ Date: <br />Accounting by: `C 4 Date: <br />ATTACHMENTS: <br />1li- Budget Estimate <br />❑ SDC Budget Worksheet <br />❑ City Engineer's Initiating O <br />❑ Request for Scoping Meeti <br />PWM/POS 100 WHITE/Fini <br />E <br />❑ Engineer's Report on Improvement Petition <br />❑ Engineering Service Work -Request ' <br />Map <br />i GOLDENROD/Project Manager July 2006 <br />