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bbb^O* <br />?•-■i <br />V -I <br />^ Public Works <br />MaintenanceLocation of <br />Wastewater Connection 1820 Roosevelt Blvd. <br />Eugend, Oregon 97402 <br />(541) 682-4800 .• ^ <br />7- <br />Property Information <br />Address . '—•—Lj—:— <br />Map and Tax Lot — <br />Building Type: @ SFD <br />UK y/ <br />Owner E^CcA^E- Ul-^- <br />□ Duplex '□ Multi-Family □Commercial □ Industrial <br />\Permit Information <br />Permit No. • ~ 0~\ ^ Oj Date of Issue <br />pipe Material __pipe Diameter, 1d— <br />□ System Development <br />__ . Inspected By LA ' <br />□ Right of Wdy Cut Permit Required <br />Installation Date ' - ( j ----------- <br />PcanMon grooM to attodt pifmi* »-w cctivciton ta potttc nwr h confbtmnaic* to Oiy tlandard* aid <br />rge - <br />( <br />1 <br />i <br />/ <br />I <br />l