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Public Works <br />Location of <br />Wastewater Connection <br />^Maintenance <br />1820 Roosevelt Blvd. <br />EugenS,- Oregon 97402 <br />(541) 682-4800 <br />Map and Tax Lot — <br />Building Type: j^"S>FD □ Duplex "□ Multi-^Family □ Commercial ,□ Industrial <br />&ic\<Lki\7e . L L(LOwner <br />Permit Information <br />Permit Mn ~ OM--■y . Date of Issue n <br />Contractor/Plumber S Pipe Material—~Ch VO Pipe Diameter_I_ <br />□ Right of Way Cut Permit'Required <br />Installation Date ------------------------------------ <br />rwm/wfal yrcnM to Mocfi print* •***■ cavrcVon fa pubih <br />□ System Development Charge <br />-tx.C.n 4 0Inspected By <br />ti ccnhnrincric* to Oty tiandardi and iptcMartfon*. <br />Public Wastewater Information: Inspec^ed^Bv ...' • <br />Index Page No. -J 7— Segment No. ^......^Contract No. <br />t 0NIfeO/ <br />> <br />5'V?V/fc <br />/ <br />|5 <br />4^.y«_Mi <br />Vi