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Public Works <br />PROJECT AUTHORIZATION FORM <br />Engineering <br />City of Eugene <br />99 E. Broadway, Suite 400 <br />Eugene, Oregon 97401 <br />Job - (541) 682-5291 <br />14ye <br />. <br />Project Title: <br />ay~ <br />(location and work description) pcw <br />Project Manager / Contact / Private Engineer: <br />PROJECT SCOPE: <br />Paving. <br />Concrete walks <br />(length) <br />Wastewater <br />Signal <br />New building construction <br />Other <br />(widths) <br />Stormwater <br />Street lights <br />Planning, other <br />r r d y V (J~.-, ~~.r <br />a <br />Bike lanes / paths-_-----_ <br />(width) <br />Setback / Curbside---_ _ <br />(width) <br />Landscaping <br />ROW required <br />Remodel <br />City _-----Assessments Private <br />Bond <br />Fed_ State ~ County FAA- <br />Account codes <br />APPROVED: <br />Project Manager _ ~2 - Date- <br />Principal Engineer ~.t-G Date- • <br />Other Manager Date <br />City Engineer.,~`G' - Date <br />FOR USE BY ADMINISTRATION ONLY <br />Capital Project No. ' 7 I~' ACK <br />~~-9C/ ~N <br /> <br />GL Title W1 11 P.4nr'Pi /~Iiai.l" <br />Assigned by - <br />a <br />Accounting by_ <br />SID ~ PB V" GL JC~ JE <br />ATTACHMENTS: <br />Date <br />Date <br />L3 City Engineer's Initiating Order ❑ Public Improvement Permit Application El Map or Drawing <br />L3 Request for Scoping Meeting <br />❑ Project Budget Summary eveloper Agreement ❑ Engineer's Report On Improvement Petition <br />❑SDC Budget Worksheet ngineering Agreement L3 Engineering Service Work Request <br />Other Dept. <br />Grant <br />WHITE /Finance YELLOW /Administration File PINK /Engineering File GOLDENROD /Project Manager April 2010 <br />FUNDING SOURCES: Check ALL applicable funding sources axed) <br />COMMENTS /SPECIAL PROJECT INFO. /INTERDEPARTMENTAL WORK DESCRIPTION: <br />