F v!• <br />Public Works <br />MaintenanceLocation of <br />Wastewater Connection 1820 Roosevelt Blvd. <br />EugenS, Oregon 97402 <br />(541) 682-4800 <br />S'S J hle.^i'^rr.aProperty Information ^ <br />Address —i— <br />Map and Tax Lot <br />Building Type: <br />Ld. <br />£ncla\](L LL(LOwner <br />^yfsFD □ Duplex □ Multi-Family □ Commercial □ Industrial <br />Permit Information <br />Permit No. _ <br />Cfl ^Qpjpe Diameter ' <br />/9-/9y.TS7- O! <br />Contractor/Plumber IT.TTS— <br />□ Right of Way Cut Permit Required <br />Installation Date --------^7 ~ IfL <br />PwmMon gnnM to attach prtwta <br />Date of Issue <br />Pipe MateriaL <br />/» <br /><r <br />□ System Development Charge <br />La.Gx5$€Inspected By <br />to pabOe <br />Public Wastewaterjnformatlon <br />Index Page No———L <br />inspect^-- <br />* Upstreom' OownstreoaiSegment No Contract No. <br />TWO WORKING DAYS BEFORE YOU DIG. CALL UTILITY ONE-CALL SERVICE AT 1-800-332-23+4 <br />y* <br />L / <br />di <br />Vz <br />Vs <br />X i <br />^“40 V <br />, i