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rW-- <br />i. <br />Public Works <br />MaintenanceLocation of <br />Wastewater 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: <br />Rd\3560 hi r id <br />--------------------------:_____Owner <br />□ Duplex □ Multi-Family □ Commercial □ Industrial <br />IfDate of Issue <br />Pipe Material f^^—'HContraotor/Plumber P<X.\ 0___Mo.lie’y Pipe Diameter. <br />□ Right of Way Cut Permit Required <br />Installation Date <br />□ System Development Charge <br />La Oq sScInspected By <br />h canfomnanct la Oty »<a>Kfard^ and »p«cfflbatfon«.Pfmhahn aranttd to attach prhota <br />Public Wastewater <br />Index Page No. <br />ormation '05pccf3; <br />DownalreomIWISegment No.i Contract No.Upstream <br />TWO WORKING DAYS BEFORE YOU DIG. CALL UTILITY ONE-CALL SERVICE AT 1-800-352-2344 <br />N <br />e© <br />i