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8 T Public Works <br />PROJECT AUTHORIZATION FORM <br />Engineering <br />City of Eugene <br />99 E. Broadway, Suite 400 <br />Eugene, Oregon 97401 <br />Job - Q (541) 682-5291 <br />Project Title: 2 64 (9Q - <br />(location and work description) <br />Project Manager Contact / Private Engineer: &VC1 , `Vl --!x ~ ~ - - <br />PROJECT SCOPE: <br />Paving _ - - - - Bike lanes / paths-_ <br />(widths) (width) <br />Concrete walks _ - _ Setback/ Curbside-_ <br />(length) - (width) <br />Wastewater Stormwater Landscaping- - <br />Signal - Street lights ROW required <br />g <br />New b lin <br />contruction ~lanping, other RemodelOther <br />l° <br />FUNDING SSJURCES: Check ALL applicable funding sources fixed) <br />City-_---Assessments --Private ------Bond _ - _ Other Dept._----__ <br />Fed _ ---State County FAA---_---- Grant <br />Account codes --5-3/ 10:2 - <br />COMMENTS / SPECIAL PROJECT INFO. / INTERDEPARTMENT <br />l 4 <br />APPROVED: <br />Project Manager Date ~ w <br />Principal Engineer Date_`_- <br />Other Manager Date <br />City Engineer Date <br />_L <br />FOR USE BY ADMINISTRATION ONLY <br />Capital Project No. -T - ACK 3a 2- ->cMa:2X- 0//'/'tz- <br />GL Title- r & yy1._ <br />Assigned by Date- - <br />Accounting by__ Date_ - <br />SID PB &.1 GL V" JCJ!!< JE--7,T01 <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 j4 Map or Drawing <br />❑ Request for Scoping Meeting <br />WHITE / Finance YELLOW / Administration File PINK / Engineering File GOLDENROD / Project Manager April 2010 <br />