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■ r- <br />s <br />Public Works <br />MaintenanceLocation of <br />Wastewater Connection 1820 Roosevelt Blvd. <br />EugenS, Oregon 97402 <br />(541) 682-4800 <br />Property Information <br />Address -------:------- <br />Map and Tax Lot —Z <br />Building Type: <br />1Urni/a A\je <br />Bruce, i a) ie.cOwner <br />□ Duplex □ Multi-Family □ Commercial □ Industrial <br />Permit Information <br />Permit No. 30 '010.39'Q /__ <br />Controctor/Plumber s / UpfcfoK)----- <br />□ Right of Way Cut Permit Required <br />Installation Date------- <br />.•SC^h-BO Pipe Diameterizi <br />Date of Issue <br />Pipe Material. <br />□ System Development Charge <br />Inspected By ___i___^___ <br />•r <br />LeiCaSSe <br />Jh ccnformnanc* to CHy Handardt and •p*cftfcotkmt.connection to pub/krwmbeiyi granted to attach prtvoit <br />Public Wastewater Information <br />Index Page No—Ul-Aj.Unspe^Upstreom DownstreamSegment No.Contract No.