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bbW , <br />Public Works <br />MaintenanceLocation of ; • • <br />Wastewater Connection 1820 Roosevelt Blvd. <br />EugenS; Oregon 97402 <br />(541) 682-4800 . <br />Property Information q^. <br />Address ------'• <br />Map and Tax Lot — <br />Building Type: <br />Arqr>)r\ A\/€. <br />• :__Owner <br />□ Duplex “□ Multi-Family □ Commercial □ Industrial <br />evn <br />^TSFD <br />Permit Information 0 ^ . <br />Permit No. In" l----------------Date of Issue_____________ <br />Contractor/PlumberM -UgO-WT — Pipe Materialiseh. HC? pipe Diameter^ <br />□ Right of Way Cut Permit Required <br />n <br />□ System Development Charge <br />Lo-Cq sflfInspected ByInstallation Date <br />PsarMon emM to aitoefi rvtrtt* twtr ccnhtctkn to pobOa trnr ti ccnformnonc* to Oty ttondonit and iptcMarVon*. <br />Public Wastewater-Information.. • <br />Index Page.No., <br />Inspected B <br />Segment No..Contract No; <br />f <br />N <br />l€’ <br />i <br />i <br />ft’-s 0.5-(o'Aet? <br />35 <br />lnf \ <br />/