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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 />Project Title:- e~l <br />" A 'A <br />T <br />(loc ' n . d work descd tion) <br />Project Manager / Contact / Private Engineer: yl , tar BA r Jac---- <br />PROJECT SCOPE: $ j <br />Paving - Bike lanes /paths-_ <br />l (widths) (width) - <br />Concrete walks- Setback / Curbside <br />(length) w dth) R <br />Wastewater - Stormwater dam' _ ~Vl_ Landscaping-- <br />Signal Street lights ROW required _ NO <br />building construction LAII Planning, other Remodel_ <br />Other <br />FUNDING SOURCES: Check ALL applicable funding sources fixed) <br />City_--- Assessments Private Bond Other Dept._---_ <br />Fed -State County FAA---_ Grant <br />Account codes _ _ <br />COMMENTS / SPECIAL PROJECT INFO. / INTERDEPARTMENTAL WORK DESCRI <br />LTlo clAe 't 4-flK, / <-~Y", 'ka 0'a dvik'kyk <br />d <br />APPROVED: 6 <br />Project Manager- Date- <br />Principal Engineer - - Date ~Q 0 - - <br />Other Manager Date _-V <br />City Engineer r% / - Date- <br />FOR USE BY ADMINISTRATION ONLY <br />Capital Project No. - -2 771_V - - ACK (DZ- I -`mac SO - <br />GL Title <br />Assigned by &4" F- lC"i J - - Date_ - <br />Accounting by_--- Date _ <br />SID _ PB--_ GL JC_-- 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 ublic Improvement Permit Application ❑ Map or Drawing <br />❑ Request for Scoping Meeting <br />l <br />WHITE/Finance YELLOW /Administration File PINK/ Engineering File GOLDENROD /Project Manager April 2010 <br />