It <br />f. <br />i! <br />Public Works <br />MaintenanceLocation of <br />Wastewater Connection <br />Xus*1 <br />1820 Roosevelt Blvd. <br />Eugend, Oregon 97402 <br />(541) 682-4800 <br />Property Information <br />Address • <br />Map and Tax Lot__ <br />Building Type:LfSFD □ Duplex □ Multi-Family □ Commercial □ Industrial <br />Owner <br />Permit Information <br />Permit No. D3l\20'O\ <br />nontrantnr/Pliimhftrx<Sf'^p)€.t^VT <br />Date of Issue <br />Pipe Material <br />// <br />-cK.HO Pipe Diameter. <br />□ Right of Way Cut Permit Required <br />Installation Date ___ <br />PwmlmloH granted to attach prtvat* <br />□ System Development Charge <br />/-a Cql ■> ^ e. Inspected By <br />connactkxi to ptMk a*rtr h ccnhnnnanca to CXy itandardu and •pacifications. <br />Public Wastewater Information <br />Index Page No.Segment No.Contract No. <br />TWO WORKING DAYS BEFORE YOU DIG, CALL UTILITY ONE-CALL SERVICE AT 1-BOO-332-23+4 <br />£ <br />r y? <br />N 4~V«G'4 <br />31 <br />IT <br />Vl6 <br />Otf is 5'deep <br />I <br />0 <br />. i