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bMb^ <br />i.:Public Works <br />, MaintenanceSCANNLocation of <br />Wastewater Connection 1820 Roosevelt Blvd. <br />Eugend, Oregon 97402 <br />(541) 682-4800 <br />wt <br />Property Information <br />Address ------—:— <br />Map and Tax Lot — <br />Building Type: ® SFD □ Duplex □ Multi-^Family □Commercial □ Industrial <br />TYSOK) LtA <br />.Vtev\<£S U-COwner <br />Permit Information <br />Permit No. _____ <br />Contractor/Plumber. <br />□ Right of Way. Cut Permit Required <br />W/NU/V^I <br />Date of Issue \Q j OM j <br />Pipe Material_Scii_yC5_ Pipe DiameterJl—<;^fV\, LPA*^ . <br />□ System Development Charge ' . <br />Inspected By _L\Installation Date <br />PcfmMon raittd to aiioch prtrtX* tm* ccnn^Von to pubth h <br />Public Wastewater Information <br />Index Page No-^1oiinspec» <br />Upstream DownstreamSegment No-Contract No. <br />TWO WORKING DAYS BEFORE YOU DIG, CALL UTILITY ONE-CALL SERVICE AT 1-800-332-2344 <br />1 <br />S'J-----1 Si'-z <br />b'> ^^2 <br />! <br />Ili'8"W <br />> <br />-6- <br />l-W1' <br />lS' <br />I fMOI <br />o 13o\l0sfTYSo^ UNaiiOa