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a <br />Public Works <br />PROJECT AUTHORIZATION FORM <br />Engineering <br />Job -7 1; <br />City of Eugene <br />99 E. Broadway, Suite 400 <br />Eugene, Oregon 97401 <br />(541) 682-5291 <br />Project Title: I~ tip ca_~`1-C7 GlY~ I e _ <br />(location and work description) <br />Project Manager / Contact / Private Engineer: ~--t'1 W -i- ` T>ca V( s <br />PROJECT SCOPE: <br />Paving <br />Concrete walks-------- <br />(length) <br />Wastewater <br />Signal <br />New building construction <br />Other <br />(widths) <br />(width) , 41Y)4- Stormwater - A Landscaping <br />Street lights <br />Planning, other <br />FUNDING SOURCES: Check ALL applicable funding sources fixed) <br />City --~---Assessments Private Bond <br />Fed_ ___--State <br />Accountcodes <br />County <br />COMMENTS / SPECIAL PROJECT INFO. / INTERDEPARTMENTAL WORK DESCRIPTION: <br />Other <br />Grant <br />APPROVED: <br />Project Manager- Date ~f- <br /> <br />Principal Engineer Date L ~f-T-Lo <br />Other Manager - Date-- _ <br />City Engineer Date Ccj lCi <br />FOR USE BY ADMINISTRATION ONLY <br />Capital Project No. -L ` - ACK C 33 z° <br />GL Title-1Y1 Km,", r j..A0-,- <br />Assigned <br />Bike lanes / paths <br />width) <br />( <br />Setback / Curbside <br />ROW required <br />Remodel <br />/g <br />Accounting by_- _ _ - _ Date <br />SID _ PB V GL ✓ JCZ 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 vlap or Drawing <br />❑ Request for Scoping Meeting <br />WHITE/Finance YELLOW /Administration File PINK/ Engineering File GOLDENROD /Project Manager April 2010 <br />