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bb$^ <br />SCANNED ^ Public Works <br />Maintenance <br />1771820 Ro.Osevelt Blvd. <br />Jr EugenS,- Oregon 97402 <br />(541) 682-4800 <br />Location of <br />Wastewater Connection * <br />Prpperty l,l>ormotlon^I.ul Lf> <br />&ts\LI LLCOwnerMap and Tax Lot <br />Building Type: p SFD □ Duplex ' Multi-Family □ Commercial □ Industrial <br />Permit Information <br />Permit No. n-0H\Z\-Pj <br />ContrqcW/Pll’mt''=-r' ExCiVvyATQ^.^ Pipe Material 'SC-K MO Pipe Diameter ^ 11 <br />□ Right of Way Cut Permit-Required <br />Installation Date --------- <br />pnmh3ic.n trvnM to Modi prfvaH <br />Date of Issue <br />□ System Development Charge <br />__ Inspected By l— ‘ ^\V<>\ <br />eemcVon to pubOa *#*»r h ccntormncric* to Oty ttandarda aid jptcflforffcrj*. <br />Public Wastewater .Information.. <br />Page ..No...—S'!-----Segment No..i-uJnspetl% _ ■ ,.N <br />uovmrtredrn Contract No.Index Upstream <br />fllr\S' <br />ii <br />■21-' <br />L j <br />\5'-3 / <br />— TT <br />CO <br />r \ <br />(Cat <br />i oi <br />n\% *2.3132 <br />MtSTUlCCPr U?