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!K <br />Location of SCANNED <br />Wastewater Connection <br />Public Works <br />Maintenance <br />1820 Roosevelt Blvd. <br />Eugene, Oregon 97402 <br />(541) 682-4800 <br />Property Information <br />Address ____:------- <br />Map and Tax Lot__—____________Owner Dane BoTtI^'T <br />Building Type: □ Duplex □ Multi-Family □ Commercial □ Industrial <br />Permit Information <br />Permit No.Date of Issue I' 10"I *1 n <br />Pipe Material.. SchW^ Pipe Diameter I <br />\k-oc\ic>~\-o\ <br />Contractor/PIumber__RfoaJvA__• <br />□ Right of Way Cut Permit Required <br />Installation Date ----- <br />Pwmhakm granted to ottocti private <br />□ System Development Charge <br />\ I v\r\ L a. C .ClInspected By <br />comactfoa to ptMfc mtwtr h conformoonct to CXy ttendardt and apocHtcationo. <br />Public Wastewater Information <br />Index Page No. <br />inspected ay _ <br />Segment No—i^2 Contract No.Downstream <br />TWO WORKING DAYS BEFORE YOU DIG. CALL UTILITY ONE-CALL SERVICE AT 1-800-332-23+4 <br />4 <br />.13'ff i 5 <br />R,3/'\ <br />\ <br />/? <br />1 <br />I1