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0 Public Works <br />PROJECT AUTHORIZATION FORM <br />Engineering <br />Job 47 q"2--- <br />City of Eugene <br />99 E. Broadway, Suite 400 <br />Eugene, Oregon 97401 <br />(541) 682-5291 <br />Project Title: <br />(location and work description) <br />oject Ma er /Contact !Private Engineer: <br />PROJECT SCOPE: <br />Paving <br />Concrete walks----- <br />(length) <br />Wastewater <br />Signal _ <br />(widths) <br />(width) <br />Stormwater <br />Street lights <br />wilding construction Planning, other <br />Bike lanes /paths-_---1--_ <br />(width) <br />Setback / Curbside-------- <br />Landscaping- <br />ROW required <br />Remodel <br />FUNDING SOURCES: Check ALL applicable funding sources fixed) <br />Cit AssessmentsPrivate <br />Fed_^----State County <br />Account codes <br />Bond Other Dept. <br />FAA_ Grant <br />APPROVED: <br />1 <br />~ry <br />M <br />Dat <br />~r~ <br />anager <br /> <br />Project <br />e <br /> <br />Principal Engineer = - - <br />Date- <br />Other Manager <br />City Engineer-e- <br /> <br />Date-- <br />Date- 1 Capital Project No. <br />GL Title--P-&)Y I- <br />Assigned by <br />Accounting by_----7" <br />SID PB Z_ GL <br />JC JE,- <br />Date <br />Date <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 />FOR USE BY ADMINISTRATION ONLY <br />ACK .3 D =0133 Z- V X L -may <br />WHITE / Finance YELLOW / Administration File PINK / Engineering File GOLDENROD / Project Manager April 2010 <br />COMMENTS / SPECIAL PROJECT INFO. / INTERDEPARTMENTAL WORK DESCRIPTION: <br />