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ybsvj? <br />Public Works <br />MaintenanceLocation of <br />Wastewater Connection 1820 Roosevelt Blvd. <br />Eugend; Oregon 97402 <br />(541) 682-4800 . <br />Property Information <br />Address --------:— <br />Map and Tax Lot <br />Building Type: <br />| All&i Dr. <br />fcavA K Boildfwa <br />FD □ Duplex □ Multi-Family □ Commercial □ Induslrial <br />Owner <br />Permit Information <br />Permit No. __iiq-oifcOQ-Qi Date of Issue ~ / /^7 <br />Contractor/Plumber. )S — Pipe Matena\-^k^/3o39p\p <br />□ System Development Charge <br />e Diameter. <br />□ Right of Way Cut Permit Required <br />Installation Date -----V 'tf'/.S--------- <br />j PirmhaScn to attocft prfwf* —w conyction fa puMo frr h contomvKTK* to Ply rtarxfarrf* ark/ tp+cttkoVon*. <br />Inspected By <br />Public Wastewater Information, <br />Index Page No., — Segment No. <br />Inspected By — <br />..,13281liowrutreorfi Contract No. <br />L- <br />I'ltJ <br /><o <br />< <br />V4.I|SSv« <br />o <br />H" <br />& <br />4l33f/£>" <br />^ ir-—^fiavCkiell RfI,