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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: T)E-P k r J LN -K <br />(location and work description) <br />Project Manager/ Contact/ Private Engineer: <br />PROJECT SCOPE: <br />Paving <br />Concrete walks <br />(widths) <br />Bike lanes / paths <br />(width) <br />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 <br />FUNDING SOURCES: Check ALL applicable funding sources (% fixed) <br />City �K Assessments Private Bond _ Other Dept <br />Fed State County FAA Grant <br />Account codes Z <br />COMMENTS / SPECIAL PROJECT INFO. / INTERDEPARTMENTAL WORK DESCRIPTION: <br />c c, 5F- � C N `DP,\ � y4 L LLS IN Rk't C--9 R .. <br />APPROVED: <br />Project Manager _ <br />Date <br />Principal Engineer <br />Date <br />Other Manager <br />City Engineer <br />Date <br />Date ".f <br />FOR USE BY ADMINISTRATION ONLY <br />Capital Project No. — ACK <br />GL Title . <br />Assigned by <br />Accounting by <br />SID P , PB o/ GL r'/ J <br />ATTACHMENTS: <br />JE <br />Date <br />;kProject 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 A Map or Drawing <br />❑ Request for Scoping Meeting <br />WHITE/Finance YELLOW/ Administration File PINK/ Engineering File GOLDENROD /Project Manager April 2010 <br />