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| bbKb <br />i <br />Public Works <br />MaintenancerSCANNEf^Location of <br />Wastewater Connectio 1820 Roosevelt Blvd. <br />Eugeng, Oregon 97402 <br />(541) 682-4800 <br />Property Information <br />Address ____:____ <br />Map and Tax Lot__: <br />Building Type: <br />757 Ar tor\d y\ome-S <br />^'SFD □ Duplex □ Multi-Family □ Commercial □ Industrial <br />Owner <br />Permit In <br />Permit No <br />Cnntrnrtnr/Plumhp.r v.. qtv'l M__ <br />□ Right of Way Cut Permit Required <br />Installation Date __I £ ~l H <br />PwrmMtton granted to attach pctvotm <br />formation <br />r Y^-oomo-Ql Date of Issue <br />Pipe Material. <br />/ • <br />ScV~\ MO Pipe Diametp.r-—^ <br />□ System Development Charge <br />La,C-aInspected By <br />h cmformnanca to Oty rtandarda and tpac/lfcatlon*connt Uoa to pubffc <br />Public Wastewater Information <br />Index Page No—spec»2 <br />DownstreornSegment No.Contract No. <br />TWO WORKING DAYS BEFORE YOU DIG, CALL UHUTY ONE-CALL SERVICE AT 1-BOO-332-2344 <br />J <br />! <br />I <br />35' <br />Argon