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-k W Public Works <br />PROJECT AUTHORIZATION FORM <br />Engineering <br />City of Eugene <br />99 E. Broadway, Suite 400 <br />Eugene, Oregon 97401 <br />Job <br />- y~ ---f-- (541) 682-5291 <br />Project Title: _ P t1- <br />ltkf `t ! 4~~~~ ~ CST, of q <br />(location and work description) <br />Project Manager Contact / Private Engineer: <br />PROJECT SCOPE: <br />Paving <br />--MASS-- ® Bike lanes / paths <br />(widths) <br />Concrete walks <br />(length) <br />Wastewater <br />Signal <br />New building construction <br />Other <br />Stormwater <br />Street lights <br />Planning, other <br />(width) <br />FUNDING SOURCES: Check ALL applicable funding sources fixed) <br />City-- '-Assessments__----__ Private Bond <br />Fed_ --State County FAA_ <br />Account codes <br />Landscaping- <br />ROW required <br />Remodel <br />Setback / Curbside <br />(width) <br />Other <br />Grant <br />APPROVED: <br />Project Manager t°~~ Date -L - <br />Principal Engineer DateD <br />Other Manager - <br />Date <br />Date <br />City Engineer - Date_ lC~ <br />FOR USE BY ADMINISTRATION ONLY <br />Capital Pro'ect`No. q1J~ 1 ACK 2- `4'3~iZ- 94Q 3V - <br />GLTitlewf -z// ~~~rcnrsu :fir, Jl t~~s,nc~C <br />Assigned by <br />I.J <br />Accounting by <br /> <br />SID ✓ PB i! GL -v- <br />JC- JE <br />ATTACHMENTS: <br />Project Budget Summary <br />OP <br />' <br />❑ Developer Agreement <br />*SDC Budget Worksheet <br />' <br />LJ <br />❑ Engineering Agreement <br />❑ City Engineer's Initiating Order <br />❑ Public Improvement Permit Application <br />❑ Request for Scoping Meeting <br />/6 <br />Date---- - - <br />❑ Engineer's Report On Improvement Petition <br />❑ Engineering Service Work Request <br />❑ Map or Drawing <br />WHITE / Finance YELLOW / Administration File PINK / Engineering File GOLDENROD / Project Manager April 2010 <br />COMMENTS / SPECIAL PROJECT INFO. / INTERDEPARTMENTAL WORK DESCRIPTION- <br />