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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: <br />(location and work descriptioW <br />Project Manager / Contact / Private Engineer: <br />PROJECT SCOPE: <br />Paving _____ <br />Concrete walks_ <br />(length) <br />Wastewater _ <br />Signal— — — <br />New building construction <br />Other <br />(widths) <br />Stormwater _. <br />Street lights _. <br />Planning, other <br />cz <br />Bike lanes / paths- - - - - <br />(width) <br />Setback / Curbside___ _ <br />(width) <br />Landscaping__ <br />ROW required <br />Remodel__ <br />FUNDING SOURCES: Check ALL applicable funding sources <br />City__ Assessments _ Private <br />Fed___ State _ County <br />Account codes <br />COMMENTS / SPECIAL PROJECT INFO. / INTERDEPARTMENTAL WORK DESCRIPTION: <br />APPROVED: <br />Project Manager �" `"'t __ - -_ Date 4 3 °/ t ? - - -- <br />Principal Engineer — _____ _ Date <br />Other Manager _ —__ Date City Engineer —__ _ Date______ <br />FOR USE BY ADMINISTRATION ONLY <br />4 1 -9351 �- <br />Capital Project No. ACK <br />GL Title Green Apartment <br />Assigned by _ AP POD w ,,. __ _ _ Date <br />By Tammy Smith at 8:44 am, May 02, 2012 <br />Accounting by_ _ _ _ Date <br />SID - _ PB _ GL JC JE / <br />ATTACHMENTS: <br />❑ Project Budget Summary Fugblic veloper Agreement ❑ Engineer's Report On Improvement Petition <br />❑SDC Budget Worksheet sneering Agreement ❑ Engineering Service Work Request <br />E3 City Engineer's Initiating Order Improvement Permit Application ❑ Map or Drawing <br />❑ Request for Scoping Meeting <br />Bond <br />F. <br />V <br />PIP <br />i <br />Other Dept. <br />Grant <br />WHITE / Finance YELLOW / Administration File PINK / Engineering File GOLDENROD / Project Manager April 2010 <br />