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Public Works <br />MaintenanceLocation of <br />Wastewater Connection SCANNE 1820 Roosevelt Blvd. <br />Eugend, Oregon 97402 <br />(541) 682-4800 <br />Property Information <br />Address <br />Map and Tax Lot__I <br />Building Type: <br />\°lOl EILlwn Dr. <br />~Tr>rdaA X\JC.rSc>r~i=---------------------:--------Owner <br />□ Duplex □ Multi-Family □ Commercial □ Industrial <br />Permit Information <br />Permit No. <br />Contractor /Plumber S EvCAvJa-'L'Opi Pipe Moterial SC^.HQ <br />□ Right of Way Cut Permit Required <br />Installation Date __L_ <br />Pwmlmhn granted to attach pchatt <br />\q-oio3M-oi Date of Issue IH ~i ^n <br />~ ■ i) <br />Pipe Diameter_i <br />□ System Development Charge <br />La Ca SSC.Inspected By <br />h conformnanca to CKy ttandarda and apacMkaVon*connactkoa to ptMfc <br />Public Wastewater Information <br />Index Page No. <br />j r , j ij?sPected ByS’!Segment No.iJownstreom Contract No.Upatreom <br />TWO WORKING DAYS BEFORE YOU DIG, CALL UTILITY ONE-CALL SERVICE AT 1-800-332-2344 <br />^ 3 <br />N 'k\SO' <br />A'5 If7" <br />uA- <br />V?3 <br />\r <br />soil <br />Dr <br />, ^ ■