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5 <br />4 <br />Public Works <br />MaintenanceSCANNED©Location of <br />Wastewater Connection 1820 Roosevelt Blvd. <br />Eugend, Oregon 97402 <br />(541) 682-4800 <br />Property Information <br />Address ^O. ^3 .57 ^30 <br />Map and Tax Lot <br />Building Type: □ SFD □ Duplex <br /><.Dr. [SHI M.Park■ ^3.^^ HO Wed- ^pcir«, <br />. -Owner ,Aloe^t 1 <br />oprvn^<LLL <br />d-TMulti-Family □ Commercial □ Industrial <br />Permit Information . . <br />Permit No. 1 O^OQO ~ & \S-3 'I ?Date of Issue // <br />Contractor/Plumber D.€..1~W-_’$rav,J (7-Pipe Mntfirinl TjO 3 W 2Pipe Diameter. <br />□ Right of Way Cut Permit Required <br />Installation Date ____R ~ (~7 i ^__ <br />□ System Development Charge <br />Inspected By 1-<kCm SSC. <br />h contomnanc* to CKy itandordu and ydlfcotfan*Ptmhtkm mmbd to ottoc/i artvato ccnnoctloa to puttie <br />Public Wastewater Information <br />Index Page No. <br />InspectedB^ <br />Segment No.-r^-^-Contract No.downstream <br />TWO WORKING DAYS BEFORE YOU DIG, CALL UT1UTY ONE-CALL SERVICE AT 1-800-332-2344 <br />/nfire A pi Co^plcv en+ers <br />pjblic 5.S. Here <br />Cu <br />g' 3o3H <br />/ <br />c