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bbb^\,]» .« <br />r ■V <br />-i Public Works <br />MaintenanceLocation of <br />Waste water Connection 1820 Roosevelt Blvd. <br />Eugene,- Oregon 97402 <br />(541) 682-4800 > . <br />Property Information <br />Address . '_:_----------- <br />Map and Tax Lot------ <br />Building Type: □ SFD <br />vAl AVE y/ <br />Owner v>P,fy> T\^<v\\nK <br />□ Duplex -□ Multi^-Family 11 Commercial □ Industrial <br />\Permit Information <br />Permit Nn. O \ ____ Date of Issue C'.'-7 iZ/1-0 <br />nr.nfrnntnr/P[iimhRr- ' pipe Material Qo__Pipe Diameterf'f-. <br />□ Right of Wdy.Cut Permit Required □ System Development i <br />Installation Date '/Z'j / ^Q_---------’------- . Inspected By <br />PtnvMon granM to attach prt*it» rnnr ccm*Mca io fXJbfc rtwtr h cenformrwnct to Oty ttarxlard* aid <br />arge <br />oVa <br />Public Wastewater Information <br />Index Page No. — Segment No. <br />Inspected By <br />Downstream Contract No.Upstream <br />TWO WORKING DAYS BEFORE YOU DIG, CALL UTILITY ONE-CALL SERVICE AT 1-800-332-2344 <br />vo (=>"^ Avs <br />I <br />I <br />- c/~ ''9 <br />s'\ <br />I11 I <br />> ^ <br />I- 6- c-o <br />« U 7 mi <br />o 1028^i <