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bbb^ 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 <br />Building Type: □ SFD □ Duplex □ Multi-Family ^k^Commercial □ Industrial <br />Li\. <br />fjhppourd n't &coopOwner <br />Permit Information <br />Permit No. <br />Con tractor/Plumber. <br />□ Right of Way Cut Permit Required <br />Installation Date -----1 f) ~ 10 ^----- <br />Date of Issue \ c)' i^l ,f <br />Pipe MateriaBO^w/^^-^fiPipe Diameterlli. ^ <br />□ System Development Charge <br />Inspected By ____Lp-C-O^S^S------------- <br />h confomwtanc* to CXy rtandarda and ipadlkodana. <br />19-0^57-01 / / <br />PtrmMon granM to aitocH pffmtm <br />Public Wastewater Information <br />Index Page No.^Hirec»55T Segment No.Contract No.DownstreamUpstream <br />TWO WORKING DAYS BEFORE YOU DIG, CALL UTILITY ONE-CALL SERVICE AT 1-800-332-2344 <br />PVFMHoN <br />^-A\\ <br />303H <br />9 <br />H" <br />C9 <br />V? <br />41 e> <br />Qvr Lrv>i