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bbSW <br />i <br />Public Works <br />^MaintenanceLocation of <br />Wastewater Connection 1820 Roosevelt Blvd. <br />EugenS,- Oregon 97402 <br />(541) 682-4800 , <br />•< <br />Property Information <br />Address -------—:— <br />Map and Tax Lot — <br />Building Type: ^SFD □ Duplex □ MultKFamily □ Commercial .□ Industrial <br />~7 CA lyr/pw Lr\. <br />Owner \\y^Aey\ Home s <br />: <br />plTl! 'f rmoW -r)/;/noi nn>B ^ i o- is -i i <br />Contractor/PI"n~»hpr. ^ .Uofl-Yn—Pipe Material—Pipe Dlameten=L_ <br />Right of Way Cut Permit Required <br />Installation Date -----1 U? " 1 J------ <br />Ptanhtton ernnM to oilocft print* —trr ctnmeiko to pubth nwtr h eonfcmnaic* to CHy tftruhnfa and ir»ctfkcVoni <br />Public Wastewater^.Information <br />Segment No. <br />□ System Development Charge <br />L<x C<x s s e <br />□ <br />Inspected By <br />Inspected By <br />3 . y 5^.11 <br />Upgtreom liownttreom3^index Page ..No Contract No.