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I bbW <br />i. <br />Public Works <br />MaintenanceLocation of <br />Wastewater Connection SCANNE 1820 Roosevelt Blvd. <br />Eugeni, Oregon 97402 <br />(541) 682-4800 <br />Property Information <br />Address _;___:__ <br />Map and Tax Lot—I <br />Building Type: ^'SFD □ Duplex □ Multi-Family □ Commercial □ Industrial <br />R^nt Av/e <br />Earba ra Ia 11Owner <br />Permit Information <br />w-oa5$\-o\Permit No.Date of Issue // <br />nrtntrnrtnr/Plumhpr ^q.rbir^ Pipe Mnterinl ■ H &Pipe Diameter. <br />□ Right of Way Cut Permit Required <br />Installation Date __ <br />PwrMan granM to ottocti p/tvoto <br />□ System Development Charge <br />La C^a $£ e <br />h conkrmnoocx to City standardt and tpodlkotkmt. <br />Inspected By <br />connection to pubBc <br />Public Wastewater Information <br />Index Page No. <br />Inspected <br />Downst/eom <br />aSegment No.Contract No. <br />TWO WORKING DAYS BEFORE YOU DIG. CALL UTILITY ONE-CALL SERVICE AT 1-800-332-2344 <br />/We. <br />■ H1,0 <br />K5’ <br />51" <br />. 6 <br />O <br />n’ <br />(ad <br />l