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Public Works <br />MaintenanceLocation of <br />Wastewater Connection 1820 Roosevelt Blvd. <br />Eugenii, Oregon 97402 <br />(541) 682-4800 <br />Property Information <br />Address _;_1;------- <br />Map and Tax Lot — <br />Building Type: <br />153) Da y Bravr-f- rPoqe,Ki <br />□ Duplex □ Multi-^-Family □ Commercial □ Industrial <br />Owner <br />Permit Information <br />Permit No. 3Q~S - 3^-^^Date of Issue <br />Pipe MateriaL <br />/'4Contractor/Plumber Pipe Diameter. <br />□ Right of Way Cut Permit Required <br />Installation Date £ (pr &C> <br />PwmMon granttd to attach pfhatt <br />□ System Development Charge <br />La.Ca5S(LInspected By <br />to pobOc h <br />Public Wastewater nfprmation <br />Index Page No. <br />Inspected B <br />1~ 1 3?A2XSegment No.Contract No.Upstream <br />TWO WORKING DAYS BEFORE YOU DIG. CALL UTILITY ONE-CALL SERVICE AT 1-800-332-2344 <br />r <br />M <br />V'fc <br />Vi <br />I <br />^-----I<33'-------^ <br />, t