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r ON <br />PROJECT AUTHORIZATION FORM W-.") Public Works <br />Engineering <br />City of Eugene <br />99 E. Broadway, Suite 400 <br />Eugene, Oregon 97401 <br />Job j i (541) 682-5291 <br />a <br />;l a <br />Project Title: <br />(location and work description) - <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 />FUNDING SOURCES: Check ALL applicable funding sources fixed) <br />City- _.7•=~~--Assessments Private Bond Other Dept. <br />Fed-- State County FAA_--_-- Grant <br />Accountcodes <br />/ SPECIAL PROJECT INFO. / INTERDEPARTMENTAL WORK DESCRIPTION: <br />APPROVED: A <br />Project Manager <br />~ - Date- ~ <br />Principal Engineer _ Date <br />- ~C~ <br /> <br />Rr <br />Other Manager Date _ <br />City Engineer - - - - Date-~r/ - <br />Capital Projec No. ~ J5' 60 <br />GL Title ,the! <br />Assigned by <br />Accounting by_- <br />ATTACHMENTS: <br />Project Budget Summary <br />❑SDC Budget Worksheet <br />❑ City Engineer's Initiating Order <br />❑ Request for Scoping Meeting <br />FOR USE BY ADMINISTRATION ONLY <br />ACK <br />JC V' JE V`0 <br />Bike lanes / paths <br />h) <br />Setback / Curbside (width) <br />Landscaping <br />ROW required <br />Remodel <br />Date <br />❑ Developer Agreement ❑ Engineer's Report On Improvement Petition <br />❑ Engineering Agreement ❑ Engineering Service Work Request <br />❑ Public Improvement Permit Application ❑ Map or Drawing <br />(width) <br />WHITE/Finance YELLOW /Administration File PINK/ Engineering File GOLDENROD /Project Manager April 2010 <br />