r- <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: ^SFD □ Duplex □ Multi-Family □ Commercial □ Industrial <br />W*. rfc-S /tUg. <br />Owner <br />Permit Information <br />Permit No.l'3Q'3o <br />r>cMHo <br />aO-OOM3/-OJ <br />Contractor/Plumber <br />Date of Issue <br />Pipe Material-HiPipe Diameter. <br />□ Right of Way Cut Permit Required <br />5-C^o <br />□ System Development Charge <br />________ . Inspected By <br />to pMfc T h canformnanc* to CHy tiocxfordm and tptctlkaVom. <br />Installation Date <br />PmmMott grant'd to ottocfi private <br />Public Wastewater Information <br />Index Page No.,——i—/-Segment No..Contract No. <br />TWO WORKING DAYS BEFORE YOU DIG, CALL UTILITY ONE-CALL SERVICE AT 1-800-332-23-44 <br />T <br />V/feV?S' <br />\ <br />//£? <br />I* <br />I