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ni <br />4 <br />Public Works <br />MaintenanceLocation of <br />Wastewater Connection 1820 Roosevelt Blvd. <br />EugenO, Oregc <br />(541) 682-4800 <br />on 97402 <br />Property Information <br />Address _;_---------- <br />Map and Tax Lot__ <br />Building Type: □ Duplex □ Multi-Family □ Commercial □ Industrial <br />. ? ISO Hecdker hrcMe. Ln, <br />5rixi? Wiecher-POwner <br />Permit Information <br />Permit No. 'ZO ' 00^5-C>\ <br />Contractor/Plumber <br />□ Right of Way Cut Permit Required <br />Date of Issue ^ "[-''Q.O /( <br />Pipe Mntfirinl MO_Pipe Diameter M <br />□ System Development Charge <br />Inspected By <br />h conformnanc* to Cfty standard* and spscMcatfons. <br />L-o-Cao.Installation Date _____ <br />Pwmhdon granted to ailocf, prtwt*connection to pubttc <br />Public Wastewater Information <br />Index Page No. <br />-Inspected By <br />Upatreom t)own3treomHISegment No.Contract No. <br />TWO WORKING DAYS BEFORE YOU DIG, CALL UTILITY ONE-CALL SERVICE AT 1-800-332-2344 <br />' & <br />IT3 <br />V?I <br />57 <br />r1 i\ <br />1 7\ <br />]l% <br />, .*