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PROJECT AUTHORIZATION FORM Public Works <br />Engineering <br />City of Eugene <br />99 E. Broadway, Suite 400 <br />Eugene, Oregon 97401 <br />Job - (541) 682-5291 <br /> <br />Project Title: <br />(location and work description) <br />Project Manager ! Contact / Private Engineer: <br />PROJECT SCOPE: <br />Paving <br />driq W111 <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 />(width) <br />Bike lanes ! paths--------- <br />Setback / Curbside (width) <br />Landscaping <br />ROW required _ <br />Remodel <br />FUNDIN SOURCES: Check ALL applicable funding sources fixed) <br />City _ Assessments Private _ Bond Other Dept. Fed State County FAA_Grant <br />Account codes <br />APPROVED: <br />Project Manager " Date <br />Principal Engineer Date_ <br />Other Manager Date__ <br />City Engineer Date ' <br />I 1~11 FOR USE BY ADMINISTRATION ONLY <br />Capital Project No. _ ACK~ia-~ 33 Z?x~~Q S~ <br />GL Title PP <br />Assigned by V _ <br />Accounting by_-_ - <br />SID ✓ PB V' GL ✓ JC <br />ATTACHMENTS: <br />JE=/- <br />Date- <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 />WHITE / Finance YELLOW / Administration File PINK / Engineering File GOLDENROD / Project Manager April 2010 <br />COMMENTS / SPECIAL PROJECT INFO. / INTERDEPARTMENTAL WORK DESCRIPTION: <br />