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PROJECT AUTHORIZATION FORM <br />Public Works <br />Engineering <br />City of Eugene <br />99 E. Broadway, Suite 400 <br />q-753 Eugene, Oregon 97401 <br />Job _ (541) 682-5291 <br />Project Title: _ 0_9_I DP_I VC 1QA i rA 4c `-t M ply \&~11/1tF1,-MF::izoM - <br />(location and work description) <br />- ~ i Tb -724 G ° r-v~------- <br />Project Manager / Contact / Private Engineer: G,~Y ` ~ z_ V L I z- x <br />PROJECT SCOPE: <br />Paving Bike lanes / paths <br /> <br />(widths) (width) <br />Concrete walks Setback / Curbside <br />(length) (width) <br />Wastewater Stormwater Landscaping--- <br />Signal Street lights ROW required <br />New building construction - Planning, other Remodel_-- <br />Other <br />FUNDING SOURCES: Check ALL applicable funding sources fixed) <br />city ----Assessments Private Bond <br />Fed-------State County FAA- <br />Account codes <br />Other Dept. <br />Grant <br />COMMENTS / SPECIAL PROJECT INFO. / INTERDEPARTMENTAL WORK DESCRIPTION: <br />60 N~,112-U&-_k)S,WF D(2*lv Ass? "PIPE wbVr- ~F~M <br />AVe-DPW i2t_Ad,E• /'.rv-fii/Er t`lIAlKI Przo '1 ~ CRZc` T 9V1lSS I <br />APPROVED: <br />Project Manager- <br />- <br />Date-- 1LoLi i <br />Principal Engineer <br />Date 7 <br />Other Manager <br />Cit <br />En <br />ineer <br />Date-- <br />Date <br /> <br />y <br />g <br />- <br /> <br />_ <br /> <br />FOR USE BY ADMINISTRATION ONLY C~ <br />Capital Project No.C 5 ' to ACK - Gem,=! f ?ff <br />GL Title <br />L~ <br />Assigned kSy'~/ - Date3 c <br />Accou7t' by Date _ <br />SID PB GL JC_ JE_ <br />.Project Budget Summary ❑ Developer Agreement ❑ Engineer's Report On Improvement Petition <br />❑SDC Budget Worksheet ❑ Engineering Agreement Q_Engineering Service Work Request <br />❑ City Engineer's Initiating Order ❑ Public Improvement Permit Application ap or Drawing <br />❑ Request for Scoping Meeting <br />WHITE/Finance YELLOW / Administration File PINK/ Engineering File GOLDENROD/ Project Manager April 2010 <br />