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s <br />Public Works <br />MaintenanceLocation of <br />Wastewater Connection 1820 Roosevelt Blvd. <br />Eugene, Oregon 97402 <br />(541) 682-4800 <br />/?n*r W. A>e.Property Information <br />Address ____:-------- <br />Map and Tax Lot__ <br />Building Type: □ SFD □ Duplex □ Multi-Family ^“Commercial □ Industrial <br />McJaren Tnuesimcni 6roopOwner <br />Permit Information <br />Permit No. O ~ Q 1 ^ " O I---------- <br />Contractor/Plumber HQ’fK—l^lc.rr <br />□ Right of Way Cut Permit Required <br />Installation Date ___'7,/ " T^.Q <br />rwmltdon granted to attach pthob <br />2-£6-30Date of Issue <br />Pipe Material_A£_S 1/VPipe Diameter. <br />□ System Development Charge <br />L cl <br />*i cantomnm* to CHy ttandordm and wpocdhodona. <br />Inspected By <br />connoctkM to potOc <br />Public Wastewater Information <br />Index Page No.- <br />Inspected By <br />\o\o\Downstream <br />lOk ft- Segment No—\jS^JJc' <br />Contract No. <br />TWO WORKING DAYS BEFORE YOU DIG, CALL UTTUTY ONE-CALL SERVICE AT 1-800-332-2344 <br />IH'X <br />I iNi W.|5 :coined ^ <br />&D <br />f7° <br />0 'In lon^ Sweep1 <br />CorinecL