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lobHov •< <br />SCANNER■i <br />Public Works <br />Maintenance <br />1820 Ro.Osevelt Blvd. <br />EugenS,-- Oregon 97402 <br />(541) 682-4800 <br />Location of ; • •. <br />Wastewater Connection <br />Property information <br />Address -------1:—■ <br />Map and Tdx Lot — <br />Building Type: ^SFD □ Duplex' '□ MultKFamlly □Commercial □ Industrial <br />MS L-yi.-': <br />l4>»Vie£> !Xvlc.Owner <br />Permit Information <br />Permit No. <br />M Loam . <br />7-/£'-)9__Date of Issue ____________ <br />_Plpe Mnterinl fx^h'HO Pipe DiameterllL. <br />□ System Development Charge <br />Inspected By Let Co. $ 5<C.___________ <br />tl txnfonrincric* to Ctfy ihndarda and tptdlkaVoo*. <br />// <br />Contractor/Plumbenl^ <br />□ Right of Way Cut Permit'Required <br />q-//~/qInstallation Date <br />, ftrmfatfcn FcnM to Mach prfurf* nr*- ccmcVen to poblh <br />Public Wastewater .Information, <br />Index Page ..No., -3^Segment No..