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f 9 <br />PROJECT AUTHORIZATION FORM Public Works <br />Engineering <br />City of Eugene <br />99 E. Broadway, Suite 400 <br />Eugene, Oregon 97401 <br />Job (541) 682-5291 <br />Project Title: I t iii,+o on _ <br />(location and work description) <br />Project Manage Contact / Private Engineer: _J <br />PROJECT SCOPE: <br />Paving <br />(widths) <br />Concrete walks <br />(length) <br />Wastewater <br />Signal <br />New building construction <br />Other <br />Stormwater _ <br />Street lights <br />Planning, other <br />Landscaping- <br />ROW required <br />Remodel <br />FUNDIN SOURCES: Check ALL applicable funding sources fixed) <br />City- -Assessments--- Private ------Bond-____ Other Dept <br />Fed_^-__-State County FAA,__,_ Grant <br />Account codes <br />APPROVED: <br />Project ManagerI <br />Principal Engineer <br />Other Manager _ <br />City Engineer A <br />FOR USE BY ADMINISTRATION ONLY <br />Date 6 <br />Date-i-TL-~__ <br />Date <br />Date <br />Capital Project No.1 - ACK -OJIR -40-57(-- <br />GL Title <br />Assigned by Date- al L14! <br />Accounting by__ _ _ Date <br />SID -V" PB_Z~ GL JCV1 JE_~ <br />ATTACHMENTS: <br />Project Budget Summary ❑ 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 or Drawing <br />❑ Request for Scoping Meeting <br />0 <br />/ <br />Bike lanes / paths <br />(width) <br />Setback / Curbside <br />(width) <br />WHITE/Finance YELLOW /Administration File PINK/ Engineering File GOLDENROD/ Project Manager April 2010 <br />COMMENTS / SPECIAL PROJECT INFO. / INTERDEPARTMENTAL WORK DESCRIPTION: <br />