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Location of 0^ <br />Wastewater Connection <br />i- <br />Public Works <br />Maintenance <br />1820 Roosevelt Blvd. <br />Eugene, Oregon 97402 <br />(541) 682-4800 <br />Property Information <br />Address ________ <br />Map and Tax Lot__: <br />Building Type: ^fSFD □ Duplex □ Multi-Family □ Commercial □ Industrial <br />Sile+z St <br />Owner <br />Permit Information <br />Permit No. <br />Contractor/Plumber <br />□ Right of Way Cut Permit Required <br />Installation Date _ <br />Pwm/m/on granted to attach prhata <br />1^-033^1-01 Date of Issue H ' 1 ~ <br />Pipe Material Pipe DiameterJlL <br />»/ <br />□ System Development ChargeUlOJsCInspected By <br />ccmaction to poblk mwr h conhrmnanc* to Oty itandardu and tpacMcation* <br />Public Wastewater Information <br />Index Page No—H3- <br />By.33Segment No.-Contract No.Upstreom <br />TWO WORKING DAYS BEFORE YOU DIG, CALL UTILITY ONE-CALL SERVICE AT 1-800-332-2344 <br />^1 <br />N <br />M <br />(D <br />\n