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PROJECT AUTHORIZATION FORM <br />Job #: L l 4 �) C 1 <br />City of Eugene <br />99 E. Broadway, Suite 400 <br />Eugene, Oregon 97401 <br />(541) 682 -5291 <br />Project Title: Z) N�4 (L-L.Q W P-3?.Q�) K 2 - F-E- N <br />(location and work description) <br />Project Manage / Contact / Private Engineer: L E-9 x ?� (DO <br />PROJECT SCOPE: <br />Paving _ <br />(widths) <br />Concrete walks <br />(length) (width) <br />Wastewater Stormwater <br />Signal Street lights <br />New building construction Planning, other <br />Other [ W C-LL._ C--L-V y Ut4 - t\ - TJ fj N <br />FUNDING SOURCES: Check ALL applicable funding sources (% fixed) <br />City X _ Assessments Private Bond Other Dept. <br />Fed_ State _ — County FAA Grant <br />Account codes 5 - �J l 2-C '2.2. Q <br />COMMENTS / SPECIAL PROJECT INFO. / INTERDEPARTMENTAL WORK DESCRIPTION: <br />APPROVED: <br />Project Manager <br />Principal Engineer <br />Other Manager _ <br />City Engineer ,„ G <br />Bike lanes / paths <br />(width) <br />Setback / Curbside <br />Landscaping_ <br />ROW required <br />Remodel <br />Date :` <br />Date <br />Date <br />Date : :A f J 1 <br />FOR USE BY ADMINISTRATION ONLY <br />Capital Project No. � to ACK 5,31 °4 3 3 2-- <br />GL Title <br />Assigned by <br />Accounting by���` G <br />SID ✓ PB _ GL <br />JC i,"� JE ' � E <br />ATTACHMENTS: <br />(AProject Budget Summary <br />❑SDC Budget Worksheet <br />❑ City Engineer's Initiating Order <br />❑ Request for Scoping Meeting <br />❑ Developer Agreement ❑ Engineer's Report On Improvement Petition <br />❑ Engineering Agreement ❑ Engineering Service Work Request <br />❑ Public Improvement Permit Application J4 Map or Drawing <br />Public Works <br />Engineering <br />WHITE/Finance YELLOW/ Administration File PINK/ Engineering File GOLDENROD /Project Manager April 2010 <br />