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? •• <br />p •i <br />Conn-uSCANNEt ©Public Works <br />Maintenance <br />i - <br />Location of <br />Wastewater 1820 Roosevelt Blvd. <br />Eugend, Oregon 97402 <br />(541) 682-4800 <br />Property Information <br />Address _:—:— <br />Map and Tax Lot — <br />Building Type: 0 SFD <br />MESrrutCCfl <br />EhLL<Wt LL.C________________:_____Owner <br />□ Duplex □ Multi-Family □ Commercial □ Industrial <br />Permit Information <br />Permit Nln \gl-C|S8.S'2~0\________Date of Issue •- <br />Cr.nfrnf'tr.r/Pinmhpr T v:' y CAPPipe Material_$Or\ UQ- pipe Dlameterri— <br />□ Right of Way Cut Permit Required <br />Installation Date — <br />PamMon amnM to attach prhat* <br />□ System Development <br />Inspected By <br />KTOOC* to ctty; <br />arge <br />^>\>t ( <br />to puMc h <br />Public Wastewater Information <br />Index Page No.^—5H <br />_, Inspected By <br />Upstreom DownstreorrSegment No.Contract No. <br />TWO WORKING DAYS BEFORE YOU DIG, CALL UTILITY ONE-CALL SERVICE AT 1-800-332-2344 <br />2l(~ V ) <br />i}-r <br />'sT\__ <br />/\ <br />11' <br />- <br />\1'yl* <br />i <br />i t\lI i <br />o22I2LO <br />NE^TUCXA L?