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bb^ <br />Public Works <br />Engineering <br />99 West 10th Avenue <br />Eugene, Oregon 97401 <br />(541) 682-8400 <br />SCANNEDLocation of <br />Wastewater Connection <br />Property Information <br />H2.QAddress <br />nooQl“7Q H 2.1, I 2 <br />S'SFD <br />Map and Tax Lot <br />Building Type: <br />Owner <br />□ Duplex □ Multi-Family G Commercial □ Industrial <br />Permit Information □ Right-of-Way Cut Permit Required <br />□ Systems Development Charge <br />Pipe Diameter <br />hUPermit No.Date of Issue <br />IS <br />Contractor/Plumber Pipe Material <br />Installation Date Inspected By <br />Permission granted to attach private sewer connection to public sewer in conformance to City standards and specifications. <br />Public Wastewater Information Inspected by <br />mi Contract No. Z-O < ^ ~ 0 - ^Index Page No.Segment No. <br />UPSTHEAM <br />TWO WORKING DAYS BEFORE YOU DIG, CALL UTILITY ONE-CALL SERVICE AT 1-800-332-2344. <br />CO# <br />t <br />fNj <br />06'(a1' ?i;c <br /><~>unns> <br />to 'l Vcc, clo <br />White - PWM Yellow - Applicant Pink - PWE/PIC Gold - PWE FilePWE 0992 Rev. 0902