US$H 3>f - <br />i <br />Public Works <br />MaintenanceLocation of <br />Wastewater Connection 1820 Roosevelt Blvd. <br />Eugeni Oregon 97402 <br />(541) 682-4800 <br />Property Information <br />Address --------:---------- <br />Map and Tax Lot-----r <br />Building Type: ^Ef-SFD <br />Lr\._____ <br />firua*. (a Kec h^r-/" <br />□ Duplex □ Multi—Family □ Commercial □ Industrial <br />Owner <br />Permit Information <br />Permit No. <br />Contractor/Plumber. <br />□ Right of Way Cut Permit Required <br />Installation Date -----/ <br />Ptrmlnhn granted to aitocti prtvata <br />l^3M3v\-c^:cno-r> i <br />rAoiile.'bn <br />Date of Issue <br />Pipe Material-7"p Pipe Diameter. <br />□ System Development Charge <br />La CaInspected By <br />xnhrmnanc* to Ctty rtandordm andh <br />Public Wastewater Information <br />Index Page No.Upatreorri ^ DownstreomHISegment No.Contract No. <br />TWO WORKING DAYS BEFORE YOU DIG. CALL UTILITY ONE-CALL SERVICE AT 1-800-332-2344 <br />T <br />N I <br />^ /6' <br />(9133’\|/Ift <br />I <br />i