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!K <br />■i <br />S- <br />Public Works <br />MaintenanceSCANNED mLocation of <br />Wastewater Conne 1820 Roosevelt Blvd. <br />Eugenis, Oregon 97402 <br />(541) 682-4800 <br />Property Information <br />Address ____:_ <br />Map and Tax Lot <br />Building Type: <br />HkkA Romy (Jr. <br />IVoie. (A-y>e<ikar~(~ <br />SFD □ Duplex □ Multi-Family □ Commercial □ Industrial <br />Owner <br />Permit Information <br />Permit No. \ *3 ~ O1^ £>~Oi_________Date of Issue . , <br />Oont^notor/Plnmhor ^-'vCC. * Pipe Material ScVv H ^ Pipe Diameter—! <br />/ ' <br />□ Right of Way Cut Permit Required <br />Installation Date 1 ' ^ i-j " ^ <br />□ System Development Charge <br />Ux 6a$£;eInspected By <br />ctxvfcVoa to pubOc otwtr In conformnanc* to CXy •tondardo and ycflfertfon*Pwmhtlon granM to attach prfvato <br />Public Wastewater Information <br />Index Page No..#3 LSegment No.Contract No. <br />TWO WORKING DAYS BEFORE YOU DIG, CALI UT1UTY ONE-CALL SERVICE AT 1-800-332-23+4 . <br />33^ b/57 <br />+f fsfe'deefOe <br />i' <~3 <br />i