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t <br />e ° U6 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: <br />(loc ion and ork description) ~ ~ <br />Project Manager / Contact / Private Engineer: <br />PROJECT SCOPE: <br />Paving _ - - Bike lanes /paths <br /> <br />- idths) (width) <br />Concrete walks---_ - - - _ Setback / Curbside----_ <br />- <br />(length) w~dthl <br />Wastewater Stormwater Landscaping <br />Wastewater <br />Street lights ROW required <br />New building construction Planning, other Remodel <br />Other <br />FUNDING SOURCES: Check ALL applicable funding sources oo 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 />APPROVED: <br />3 t <br />Project Manager. ~ <br /> <br />Date- <br />i--- <br />- <br />na► t~~i <br />' <br />Principal Engineer <br />9-. _ <br />? <br />- Date 3- f ik <br />~ - <br />- <br />_ <br />~ <br />~ <br />1 - - <br />Other Manager _ p <br />Engineer <br />Cit <br />Date <br />Date~ <br />- <br />y <br />- <br />FOR USE BY ADMINISTRATION ONLY <br />Capital Project No. <br />GL Title <br />Assigned by _ <br />Accounting by <br />ACK <br />SID _ PB-- GL JC,- JE_-- <br />ATTACHMENTS: <br />❑ Project Budget Summary ❑ Developer Agreement <br />❑ SDC Budget Worksheet )d Engineering Agreement <br />❑ City Engineer's Initiating Order -Public Improvement Permit Application <br />❑ Request for Scoping Meeting <br />Date <br />Date <br />❑ Engineer's Report On Improvement Petition <br />❑ Engineering Service Work Request <br />❑ Map or Drawing <br />WHITE/Finance YELLOW /Administration File PINK/ Engineering File GOLDENROD/ Project Manager April 2010 <br />