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Public Works <br />PROJECT AUTHORIZATION FORM <br />Engineering <br />-7 <br />Job --q711-7 <br />(widths) <br />Project Title: _;LJV l I C . L•fF~/!V <br />(location and work description) <br />Manager LZontact I Private Engineer: <br />PROJECT SCOPE: <br />Paving <br />Concrete walks----- <br />(length) (width) <br />Wastewater Stormwater <br />Signal <br />New building construction <br />Other <br />City of Eugene <br />99 E. Broadway, Suite 400 <br />Eugene, Oregon 97401 <br />(541) 682-5291 <br />Bike lanes !paths-_---- <br />(width) <br />Setback / Curbside <br />Landscaping <br />Street lights - ROW required <br />Planning, other d Remodel <br /> <br />,F~.~~ci ~%a~~~ ~t~. ~c~et~rt~►3"r'J6d~ l°~ f~©~y~ ye!l. <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 6-- <br />COMMENTS ! SPECIAL PROJECT INFO. ! IN ER EPARTMENIAL YVORK ~pESCRIPTION: <br />(e--~Plwem deC0.r,;r1,1 66JA /4 q6~~04M"~~, Wilk <br />APPROVED: <br />Project Manager <br />- <br />Date-.2 <br />V6 -oil <br />- <br /> <br />Principal Engineer <br />Date_y <br />r <br />Other Manager - <br /> <br />- Date <br /> <br />City Engineer _ - <br />- <br />Date_2// 7 <br />FOR USE BY ADMINISTRATION ONLY <br />, r< 7~,r 7f,Y 91/_f.z_- <br />Capital Project No.~~ ACK 53 <br />p~IyVl tai t9~']_ G~ on o n('. <br />GL Title 6V-n -0- La <br />Assigned <br />Accounting by_- / <br />SID _ PB-✓ GL _ JC_-Vl JE_1W <br />Date' , - <br />Date_ - <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 />