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Public Works <br />PROJECT AUTHORIZATION FORM <br />Engineering <br />Job <br />City of Eugene <br />99 E. Broadway, Suite 400 <br />Eugene, Oregon 97401 <br />(541) 682-5291 <br />Project Title. `AV10i1`?' ~i ld~ ~ hl-Jt~ hx~>~~d~ld ~ 0 6t,~ <br />(location and work description) <br />70 <br />Project Manager / ContactJ-P..riuate-Eiineer: ~ - <br />PROJECT SCOPE: <br />Paving <br />(widths) - <br />Concrete walks - <br />Wastewater <br />Signal <br />New building construction <br />Other <br />(length) (width) <br />Stormwater <br />Street lights <br />Planning, other <br />Bike lanes / paths----12 <br />(width) <br />Setback / Curbside <br />Landscaping -10 ROW required _ A V <br />Remodel <br />FUNDING SOURCES: Check ALL applicable funding sources fixed) <br />City_---Assessments Private - Bond- Other Dept. <br />*131'S Fe -State County FAA--_-- Grant <br />Account cones <br />COMMENTS / SPECIAL PROJECT INFO./ INTERDEPARTMENTAL WORK DESCRIPTION: <br />Assigned t Date - QZf~/~ <br />Accountinng by_- - _ Date <br />SID _ j!! PB p/ GL - JC V JE <br />AT HIMENTS: <br />Project Budget Summary ❑ Developer Agreement ❑ Engineer's Report On Improvement Petition <br />❑ SDC Budget Worksheet ❑ Engineering Agreement ❑ Fingineering Service Work Request <br />L3 Request for Scoping Meeting <br />WHITE/Finance YELLOW /Administration File PINK/ Engineering File GOLDENROD / Project Manager April 2010 <br />APPROVED: <br />Project Manager- % - Date --%e "?d <br />Principal Engineer - - _ Date-- L <br />Other Manager - s _ _ Date <br />City Engineer Date <br />FOR USE BY ADMINISTRATION ONLY <br />Capital Project No U J 2- - ACK 933Z- &-XXX)6 - <br />GL Title I-) 1 @~~^- - <br />❑ City Engineer's Initiating Order ❑ Public Improvement Permit Application Map or Drawing <br />