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-bbVl■ y <br />CAI4NED Public Works <br />MaintenanceLocation of <br />Wastewater Connection 1820 Roosevelt Blvd. <br />Eugend, Oregon 97402 <br />(541) 682-4800 <br />Property Information <br />Address _;__l___ <br />Map and Tax Lot_I <br />Building Type: 8 SFD □ Duplex □ Multi—Family □Commercial □ Industrial <br />2-) 2. LA CA ST <br />CU7Owner <br />Permit Information <br />Permit No. <br />Contractor/Plumber_______________ <br />□ Right of Way Cut Permit Required <br />Installation Date CA — <br />\q-c2PiM<?-o\ <br />Pipe Material __ pjpe Diameter M <br />Date of Issue <br />□ System Development Charge <br />Inspected By _______________ <br />h contormnanc* to CXy tiandarth and aMcMbottn*Pwmhthn granM to aitocti prteit* <br />Inspected By <br />--------Contract No. — <br />Public Wastewater Information <br />Index Page No.£4 £440Segment No.Upstream <br />VtfO WORKING DAYS BEFORE YOU DIG, CALL UTILITY ONE-CALL SERVICE AT 1-800-332-2344 <br />>N <br />2^4 <br />r <br />l <br />^40 i <br />Ikoi0 <br />LACASe\ ST 'ZTSM