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r <br />Public Works <br />MaintenanceSCANNEfi^^Location of <br />Wastewater Connection 1820 Roosevelt Blvd. <br />Eugen6, Oregon 97402 <br />(541) 682-4800 <br />Property Information <br />Address - ' ■ '__3H75 6, IK am <br />Chri^-tine Ca.\rr^D?)l~Tim anrMap and Tax Lot _r~~ <br />Building Type: ^TSFD <br />--------------------------------------Owner <br />□ Duplex □ Multi-Family □ Commercial □ Industrial <br />Permit Information <br />Permit No. VS*" 003 iO ~C> \_____ <br />Contractor/Plumber. A. ____ <br />□ Right of Way Cut Permit Required <br />Installation Date <br />Pwml—hn granted to attach privata <br />i'Date of Issue <br />Pipe Material DiameterJll_Pipe <br />□ System Development Charge <br />L-<x Ca £S (La-iq-Inspected By <br />h conformnanco to Ctty otandarda and tpacMcatlon^ <br />Public Wastewater Information <br />Index Page No <br />Inspected By <br />m/79 15’ll'8 <br />Upstream <br />SI Segment No.Contract No.Downstream <br />TWO WORKING DAYS BEFORE YOU DIG. CALL UTILITY ONE-CALL SERVICE AT 1-800-332-2344 <br />T <br />bJ <br />£ <br />*4-s: <br />i <br />3)37 ’/?/OO 0 I / <br />in <br />7 <br />t ■