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t bbIS'L <br />L <br />Public Works <br />MaintenanceLocation of <br />Wastewater Connecti SCANNED 1820 Roosevelt Blvd. <br />Eugene, Oregon 97402 <br />(541) 682-4800 <br />Property Information <br />Address ____:____ <br />Map and Tax Lot — <br />Ar^n^\ A\/£. <br />. _______:_____Owner _Morr\/*A XVig:. <br />Building Type: SFD □ Duplex □ Multi-Family □ Commercial □ Industrial <br />Permit Information _ <br />Permit No. 00535^ ^Ol <br />Cnntrnntnr/Plumhfir Cj<JLr\A H Lpfl <br />□ Right of Way Cut Permit Required <br />Installation Date -^5'1 f ~ ______ <br />PwmMon granM to attach prtvat* conn^Ooa to pMc <br />I -c?9-19 //Date of Issue <br />Pipe Material_Diameter—^Pipe <br />□ System Development Charge <br />Uol f.nInspected By <br />*i ccnformnanc* to CKy rtandardi and ydtktrtkn*. <br />Public Wastewater Information <br />Index Page No—3L} <br />Inspected By —H ^3<feSegment No.Contract No.Downstream <br />TWO WORKING DAYS BEFORE YOU DIG, CALL UTILITY ONE-CALL SERVICE AT 1-800-332-2344T <br />N <br />/' <br />% <br />\ <br />i <br />0 <br />1