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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: 2.&1°1 <br />(location and work description) <br />Project Manager / Contact / Private Engineer: JC44 (k W I (1~ <br />PROJECT SCOPE: <br />Paving - - (widths) <br />Concrete walks- _ <br />(length) <br />SL <br />(width) <br />Wastewater Stormwater - <br />Signal Street lights <br />New building construction Planning, other <br />Other pi[d_~G1!'k1P~~til T~ <br />- a ACK <br />FUNDING SOURCES: Check ALL applicable funding sources fixed) <br />City_-X---Assessments Private Bond Other Dept. <br />Fed__ --State ---County ---_._--FAA_----- Grant <br />Account codes <br />COMMENTS / SPECIAL PROJECT INFO. /1 INTERDEPARTMENTAL WORK DESCRIPTION: <br />4 I~li.[y✓ 1 Yl ~.i-4YIJrY, (A 6A-Pi Tra i ` 1 S 1 Yq, - <br />APPROVED: <br />Project Manager- <br />Date <br />l y_~~/- <br />Principal Engineer <br /> <br />Date ~ ~~1 <br />Other Manager <br />Cit <br />Enginee <br /> <br />Date <br />D <br />t <br />r <br />- <br />y <br />_ <br />a <br />e_ a- <br />FOR USE BY ADMINISTRATION ONLY <br />Capital Project No. - `t I <br />GL Title V1 ( G <br />Assigned y , _ <br />Accounting by <br />SID tPB_ <br />T GL r/ <br />0 <br />Bike lanes / paths ~b =1 Z <br />(w;d <br />Setback/ Curbside ` l &~oG <br />Landscaping_ <br />ROW required <br />Remodel_ <br />-!eX>, 1GX- F/ 5S <br />Date_ 2~~6- - <br />Date_-- - <br />JC J <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 />WHITE / Finance YELLOW / Administration File PINK / Engineering File GOLDENROD / Project Manager April 2010 <br />