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r f <br />Public Works <br />PROJECT AUTHORIZATION FORM <br />Engineering <br />Job - LO If(? <br />City of Eugene <br />99 E. Broadway, Suite 400 <br />Eugene, Oregon 97401 <br />(541) 682-5291 <br />Project Title: _~CJ I 0- j v a -!4,M CYI V WV r i-) P`n------- - <br />(location and work description) <br />/ Contact / Private Engineer: <br />PROJECT SCOPE: <br />Paving <br />Concrete walks <br />(length) <br />Wastewater <br />Signal <br />Stormwater <br />Street lights <br />(width) <br />New building construction Planning, other <br />Other V1 <br />FUNDING SOURCES: Check ALL applicable funding sources fixed) <br />Cit!' L 3t3Assessments-_----_- Private <br />Fed _-----State County - <br />Account codes <br />Bike lanes / paths-_---- <br />(width) <br />Setback / Curbside <br />Landscaping---- <br />ROW required <br />Remodel <br />Bond Other <br />FAA_ Grant <br />COMMENTS / SPECIAL PROJECT INFO. ! INTERDEPARTMENTAL WORK DESCRIPTION: <br />✓ a M s ' i ~`-rues -61 & j1~ 11 <br />APPROVED: / <br />Project Manager Date <br />Principal Date._~= <br />Other Manay~~ Date- <br />City Engineer - Date_ ta:b If <br />FOR USE BY ADMINISTRATION ONLY <br />Capital Project No. <br />GL Title 4 h e n__ <br />Assigned by <br />Accounting by_ <br />SID _ PB Z GL <br />JC v 7v JE <br />Date <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 />