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66 <br />i <br />Public Works <br />MaintenanceLocation of . • <br />Wastewater Connection 1820 Ro.Osevelt Blvd. <br />EugenS,- Oregon 97402 <br />(541) 682-4800 ; <br />* <br />.S,n"on^ Mou^od Dr, ^___7_______ , <br />Map and Tax Lot___~ r-----— Owner Kery-n.eth oM ejln OCofy?e|l <br />. Building Type: j^SFD □ Duplex’MultH-Family □ Commercial .□ Industrial <br />Permit Information ^ , <br />Permit No. 1 4|_______^Date of Issue <br />Contractor/PlHmh‘°r ~ • -Pipe Material.^ch■ Pipe Diameter. <br />□ Right of Way Cut Permit'Required □ System Development Charge <br />^ ~ I 3 ~ 1 n_____!____ Inspected By La: C,g£€C_________ <br />5- 3 <br />Installation Date ____ <br />PrtmMon crvnM to aitodx prfvcU 9*wtr txrfHcVco fa poblfa r*nr h cenhmnonc* to Oty rioxfcnft and tptcmyytion*. <br />Public Wastewater Information.. <br />Index Page .No., <br />Inspected <br />eowniirearn <br />Segment No. 3-^19-^SJ.Contract No.Upstream