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bbbbI ,5 . <br />V <br />Public Works <br />MaintenanceWastewater ConnectieSCANNED <br />1820 Roosevelt Blvd. <br />Eugene:, Oregon 97402 <br />(541) 682-4800 <br />Property Information <br />Address - <br />Map and Tax Lot__ <br />Building Type: <br />fxferli/M feuK PL.$ <br />ixkx.lley Ki'p-fr-r Holchr>g> <br />□ Duplex □Multi-Family □Commercial □ Industrial <br />wner <br />Permit Information <br />Permit No. Iff-0^0 H ^ __ <br />Contmetor/Plumher ^ pjpf. Mntorinl SoVt.^Q pjpe Diameter^ <br />□ System Development Charge <br />Inspected By 31 WX IZ-g.d.aS^'g <br />connection to public Maw h conformnonco to CHy ttandardm and tpodficailona. <br />ll-3Q-/gDate of Issue <br />□ Right of Way Cut Permit Required <br />Installation Date _____~ I Ll ~ I _____ <br />PwmMonprantod to attach prhatm <br />Public Wastewater Information <br />Index Page No.mfeT P lWs-7 <br />Upstreom Downs tr»3mSegment No.Contract No. <br />TWO WORKING DAYS BEFORE YOU DIG, CALL UTTUTY ONE-CALL SERVICE AT 1-BOO-332-2344 <br />.S-WVwg {VVL PL <br />i S'7H <br />|0 - dee?tt <br />H\ <br />34- <br />V/b <br />37 <br />/ <br />\