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Vs ■ <br />? : <br />CANNE! ^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___Z <br />Building Type: <br />%2aR c±OITK <br />-firoce, Vyie<ihgr4~Owner <br />□ Duplex □ Multi-Family □ Commercial □ Industrial <br />Permit Information <br />Permit No. <br />Contractor/Plumber <br />□ Right of Way Cut Permit Required <br />Installation Date <br />Pwmimktt granted to attach pctsatt <br />19- O3ol$-01 Date of Issue // <br />Pipe Mntfirinl __Pipe Diameter^ <br />□ System Development Charge <br />La Lasses6-io-iq Inspected By <br />*i canfafmffflno to Oty itandarxM and tpadrtoMcrt*.connection to put/fc <br />Public Wastewater Information <br />Index Page No. <br />Inspected By _ <br />377/ 31370 <br />*trcam Downstream£3 Segment No.Contract No. <br />TWO WORKING DAYS BEFORE YOU DIG, CALL UTILITY ONE-CALL SERVICE AT 1-800-332-2J44 <br />73/ <br />N <br />I <br />9G' <br />& <br />3 <br />O-ft'S <br />37 <br />I <br />. I