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5 <br />F <br />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 />Project Title: <br />description) <br />Contact / Private Engineer: <br />PROJECT SCOPE: <br />Paving <br />- (widths) - - <br />Concrete walks <br />(length) (width) <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 _ <br />Fed___, State County - <br />Account codes <br />COMMENTS / SPECIAL PROJECT INFO. / INTERDEPARTMENTAL WORK DESCRIPTION: <br />h <br />'°a.. <br />9 <br />APPROVED: <br />Project Manager <br />Date <br />Principal Engineer <br />Date- <br />54z-Other Manager <br />City Engineer <br />Date <br />Date i <br />I /I FOR USE BY ADMINISTRATION ONLY <br />Capital Project No _ ACK c3~,2 `g33z - (~xxs <br />Assigned by Date--- <br />Accounting by_, Date_ _ <br />SID PB-J!!~- GL L! _ JC_/ JE:Z <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 />WHITE / Finance YELLOW / Administration File PINK / Engineering File GOLDENROD / Project Manager April 2010 <br />I i pit,,.,, i <br />Bike lanes / paths- <br />(width) <br />Setback / Curbside <br />Landscaping______ <br />ROW required V_ <br />Remodel <br />Bond Other Dept. <br />FAA-___ Grant <br />