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f.•< <br />Public Works <br />i MaintenanceLocation of <br />Wastewater Connect!SCANNEC 1820 Roosevelt Blvd. <br />Eugend, Oregon 97402 <br />(541) 682-4800 ___ <br />•4 <br />• T-' <br />Property Information <br />Address ' li—:-------- <br />Map and Tax Lot--------- <br />Building Type: H SFD □ Duplex □ Multi-Family □Commercial □ Industrial <br />Sium si <br />Owner <br />Permit Information <br />Permit No. _ <br />Contractor/Plumberj__—.— <br />□ Right of Way . Cut Permit Required <br />Installation Date <br />PermMai arant*d to attach prtvotm <br />0^/20 fA <br />•___Pipe Material_MQ . Pipe <br />□ System Development Charge <br />___ . Inspected By —LAcA^Cf <br />Date of Issue <br />Diameter_y>__ <br />iki17 l ^j-W <br />inane* to CHy ttcrxJord* andto <br />Public Wastewater Information <br />Index Page No.,4-1 Contract No.DownatredmUpstream <br />TWO WORKING DAYS BEFORE YOU DIG, CAa UTILITY ONE-CALL SERVICE AT 1-800-332-2344 <br />) <br />nJ 7' <br />!v'k - v j4 I <br />I <br />I ( <br />i ii\loo o <br />ll\loO N