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Public Works <br />PROJECT AUTHORIZATION FORM <br />Engineering <br />Job -A/-1_! z - <br />Project Title: _ 8 _ , Pam - ~ 4 <br />(location and work description) <br />-k)-1 9ti C~ fps i. <br />Project Manager / Contact / Private Engineer: 1 i 1 ra? <br />PROJECT SCOPE: A <br />Paving <br />(widths) <br />Concrete walks- _ <br />(length) <br />Wastewater 66 <br />Signal <br />City of Eugene <br />99 E. Broadway, Suite 400 <br />Eugene, Oregon 97401 <br />(541) 682-5291 <br />Bike lanes (paths-_----_--_ <br />(width) <br />Setback / Curbside <br />(width) <br />Stormwater Landscaping-- <br />Street lights ROW required <br />New building construction Planning, other <br />Other <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 IEa~:~s _ 'I \ - C N?~ 61 <br />COMMENTS / SPECIAL PROJECT INFO. / INTERDEPARTMENTAL WORK DESCRIPTION: <br />-3 3 2- Y, <br />APPROVED: <br />Project Manager_ <br />Principal Engineer <br />Other Manager <br />City Engineer-~Y'-- <br />Date° <br />Date- S t l® f t--- <br />Date__ <br />Date- <br />Capital Project No. <br />~~o.1 <br />GL Title IM AT <br />AT <br />Assigned by-- <br />Account' g by_ <br />SID A PB ✓ GL <br />FOR USE BY ADMINISTRATION ONLY <br />ACK _ , X32 - l~ wX=~1~ - <br />JC Ar JE_-- <br />Date <br />AT ACHMENTS: <br />C-1 Project Budget Summary ❑ Developer Agreement El 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 />