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. bbHH\ <br />Public Works <br />MaintenanceSCAN N; mLocation of <br />Wastewater Connection 1820 Roosevelt Blvd. <br />Eugene, Oregon 97402 <br />(541) 682-4800 <br />Property Information <br />Address _;_1;--------- <br />Map and Tax Lot------ <br />Building Type: □ SFD <br />LUC________________:__—__Owner <br />□ Duplex □ Multi-^-Family Commercial □ Industrial <br />Permit Information <br />Permit No. <br />Contractor/Plumber <br />Date of Issue_ <br />Pipe Material C-U'X'pco Pipe Diameter. <br />□ System Development Charge v. . <br />Inspected By L-^Q>(Ta .L— <br />tp*cl/fcaUcn*. <br />□ Right of Way Cut Permit Required <br />Installation Date <br />kt conformnanc* to Oty tiandordt andtopubtfcPermUtiai granM to attach private <br />Public Wastewater Information <br />Index Page No,.ut,n ln3pec^2BdSegment No.Contract No.DownstreamUpstream <br />TWO WORKING DAYS BEFORE YOU DIG, CALL UTILITY ONE-CALL SERVICE AT 1-800-332-2344 <br />VM o <br />IT <br />I <br />i <br />i <br />!\s' <br />~ (o' co fUwVvc <br />4 an0------\ <br />?H <br />gftlLLl Hitto— <br />I