New Search
A Public Works <br />PROJECT AUTHORIZATION FORM <br />Engineering <br />City of Eugene <br />99 E. Broadway, Suite 400 <br />Eugene, Oregon 97401 <br />Job (541) 682-5291 <br />Project Title: <br />(location and work description) <br />` ~ X 14 P AA114 OEZO N, S~C G~ <br />Contact / Private Engineer: x 9o <br />PROJECT SCOPE: <br />Paving <br />(widths) <br />Concrete walks--,_------- <br />(length) <br />Wastewater Stormwater <br />Signal Street lights <br />New building constructio Planping, other <br />Other <br />(width) <br />Bike lanes /paths-_---~--_ <br />(width) <br />Setback / Curbside <br />Landscaping- <br />ROW required <br />Remodel <br />FUNDING SOURCES: Check ALL applicable funding sources fixed) <br />City_- Assessments------__ Private Bond Other Dept._---_-__ <br />Fed - -State County FAA--_-- Grant <br />Account codes 1-15-02 <br />APPROVED: <br />Project Manager <br />Date' ~'lI <br />Principal Engineer <br /> <br />Date 2 <br />Other Manager <br />En <br />inee <br />" <br />Cit <br />Date--- _ <br />Date <br />~Jff7 <br />g <br />- <br />y <br /> <br /> <br /> <br />Capital Project No. --I GL Title 1 77"_~>ru l t 6?6071 'Eay, <br />Assigned by ` ✓ - - <br />Accounting by_- - <br />SID PB_,,-GL _JC b/"JE~S <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 />FOR USE BY ADMINISTRATION ONLY <br />ACK _ 3 -3z' lC®xK <br />i5s' <br />