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bb^°\' v <br />7 <br />Location of SCANNFrP^ <br />Wastewater Connection • s * S*§p <br />Public Works <br />Maintenance <br />1820 Ro.Osevelt Blvd. <br />Eugeni,-' Oregon 97402 <br />(541) 682-4800 . <br />Property Information <br />Address ------—:-------- <br />Map and Tax Lot----- <br />Building Type: ^TSFO <br />fifucg. lA^iP.c.Vie-rt~ ^C)r)1e,? <br />□ Duplex '□ Multi-Family □ Commercial □ Industrial • <br />Owner <br />' <br />Permit Information <br />Permit No. ----- <br />Controctor/PlHmhpr.'-'T~Mf>^ •P'ldC..— Pipe MaterialPipe Diameter-M <br />□ Right of Way Cut Permit Required □ System Development Charge <br />_______’____ Inspected By Lfr-Cr? __________ <br />05083-01 Date of Issue 7 / 9~// <br />Installation Date <br />Prmhrton grcnM fo alioch prfxrf* eowctfon to pfWfc T h contomncnc* to Oiy rtarxfenfc and tpocMajtia*. <br />Public Wgstewater.^nformation <br />Index Page ..No.,-----D o Ca_x / I . Qr\^' I iSegment No.Contract No.Upstreom Dayan tTBorn <br />/\ <br />L <br />r <br />I <br />7 <br />c?tt <br />. I <br />I <br />B <br />i <br />Ml 7-1