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PROJECT AUTHORIZATION FORM <br />Job #: <br />City of Eugene <br />99 E. Broadway, Suite 400 <br />Eugene, Oregon 97401 <br />(541) 682 -5291 <br />Project Title: D r- P W Q R) Z Ql L/ - <br />(location and work description) <br />Project Manager / Contact / Private Engineer: Q C t) t W G F % L i �b o <br />PROJECT SCOPE: <br />Paving Bike lanes / paths <br />(widths) (width) <br />Concrete walks Setback / Curbside <br />(length) (width) <br />Wastewater Stormwater X Landscaping <br />Signal Street lights ROW required <br />New building construction Planning, other Remodel <br />Other M.'t \LJE LL.t M- N INT M <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 S; i Q l 2.2 <br />COMMENTS / SPECIAL PROJECT INFO. / INTERDEPARTMENTAL WORK DESCRIPTION: <br />VIEW! kmm <br />UU. <br />APPROVED: <br />Project Manager <br />_ Date 2— <br />Principal Engineer <br />Date xo__ 1 2 <br />Other Manager <br />City Engineer <br />Date <br />Date �Z- <br />_ <br />FOR USE BY ADMINISTRATION ONLY <br />Capital Project No. _ J i� ACK _ 3 E 2 3 3 Z° �o ro7r <br />GL Title ��74 <br />Assigned by Date !E4&5 - / /® <br />Accounting by Date <br />SID ,,-' PB `� GL ,/ JC V JE <br />ATTACHMENTS: <br />§kProject Budget Summary ❑ Developer Agreement ❑ Engineer's Report On Improvement Petition <br />❑SDC Budget Worksheet El Engineering Agreement ❑ Engineering Service Work Request <br />❑ City Engineer's Initiating Order ❑ Public Improvement Permit Application KMap or Drawing <br />❑ Request for Scoping Meeting <br />Public Works <br />Engineering <br />WHITE/Finance YELLOW /Administration File PINK/ Engineering File GOLDENROD/ Project Manager April 2010 <br />