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bbSo^ <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: ^"SFO <br />\U 9jO <br />KiKe- SieaevOwner <br />□ Duplex □ Multi-Family □ Commercial □ Industrial <br />Permit Information ____ <br />Permit No. <br />Contractor/Plumber. <br />□ Right of Way Cut Permit Required <br />Installation Date —^----- <br />ParmMbn granted to attocti prtvatm <br />Date of Issue I ~l tl <br />Pipe Mntf>rinl • HO Pipe Diameter^—Br<JLUV^ ElCC. <br />□ System Development Charge <br />Inspected By ____La Ca <br />h confomnonco to Ctty otandardo and ycHhathno.ccmoctkm to pobBc <br />Public Wastewater nformatlon <br />141 <br />Inspected By - <br />Segment No.Index Page No.Contract No. <br />TWO WORKING DAYS BEFORE YOU DIG, CALL UTILITY ONE-CALL SERVICE AT 1-800-332-2344 <br />A <br />I <br />V/6 <br />i <br />v? <br />o <br />'