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'% hb3> 6 s <br />■ir <br />Public Works <br />MaintenanceLocation of <br />Wastewater Connect!1820 Roosevelt Blvd. <br />Eugene, Oregon 97402 <br />(541) 682-4800 <br />Property Information <br />Address ■HvOH (CT, <br />Map and Tax Lot <br />Building Type: ^{)fsFD □ Duplex □ Multi-Family □ Commercial □ Industrial <br />Owner <br />Permit Information <br />Permit No.^-01,021 -Ol Date of Issue S' S ~ 1 ^ <br />Contrnntor/Plumher___Pipe Mnterinl ScYyMO <br />// <br />Pipe Diameter_i <br />□ Right of Way Cut Permit Required <br />Installation Date , <br />Ptrmhtkin granted to attach prhata <br />□ System Development Charge <br />Inspected By <br />tn conformnanca to Oty atandorda and tpacMcatfona.camoctkM to pubOa <br />Public Wastewater Information <br />£3 JTgPectec^y <br />Up sir com Downstream ^Index Page No.Segment No.ontract No. <br />TWO WORKING DAYS BEFORE YOU DIG, CALL UTILITY ONE-CALL SERVICE AT 1-800-332-2344 <br /><- <br />Or30^- <br />#237733' <br />ft <br />3-h 5 ^ <br />V? <br />i <br />3o ! <br />/