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r <br />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: P-P - ( _ C, r- ' -i-3 il, - orkla ~ r d f2- I4 y <br />(location and work description) <br />Project Manage)/ Contact / Private Engineer: <br />PROJECT SCOPE: <br />Paving <br />(widths) <br />Concrete walks--- <br />(length) <br />Wastewater <br />Signal <br />New building construction <br />Other <br />Stormwater - <br />Street lights <br />Planning, other <br />FUNDING SOURCES: Check ALL applicable funding sources fixed) <br />City---Assessments Private Bond Other Dept <br />Fed ---State County FAA--__ Grant <br />Account codes <br />COMMENTS / SPECIAL PROJECT INFO. / INTERDEPARTMENTAL WORK DESCRIPTION: <br />-71,k Ca t A, I , i i/I a- 19 <br />44h-- --per? t rM RA. <br />V U. 5 APPROVED: Jp V a <br />_ <br />Date- <br />Project Manager t if <br />Principal Engineer ILL. Date <br />Other Manager 1-11 Date- <br />City Enginee Date _ <br />FOR USE BY ADMINISTRATION ONLY <br />Capital Project No. i6n.34 yi-- ACK 3%g_c33-k-(st'aG? XXf 0 4L <br />.J _ Date_all~ <br />Assigned byl <br />6-1 <br />Accounting by_ Date <br />SID ✓ PB GL Ji" JCJE_/ <br />ATTACHMENTS: <br />Project 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 Map or Drawing <br />❑ Request for Scoping Meeting <br />lla-PI4~5- <br />Bike lanes / paths_____ <br />(width) <br />Setback / Curbside- <br />(width) <br />Landscaping-- <br />ROW required _ <br />Remodel <br />WHITE / Finance YELLOW / Administration File PINK / Engineering File GOLDENROD / Project Manager April 2010 <br />