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!!• <br />5. <br />V <br />Public Works <br />MaintenanceLocation of <br />Wastewater Connection SCANN 1820 Roosevelt Blvd. <br />EugenO, Oregon 97402 <br />(541) 682-4800 <br />Property Information <br />Address ____:____ <br />Map and Tax Lot — <br />Building Type: B! SFD □ Duplex □ Multi-Family □ Commercial □ Industrial <br />Owner <br />Permit Information <br />Permit No. <br />Contractor/Plumber. <br />□ Right of Way Cut Permit Required <br />Installation Date ^ <br />gjjWlfcgfat granted to attodi primt* <br />o\ <br />WJPIJTON/ <br />Date of Issue <br />Pipe Material Pipe Diameter <br />□ System Development Charge . Inspected By OqVO <br />h canfomnanc* to CXy ttandordm and ifMcUkation*.connection to potrtc <br />Public Wastewater Information <br />Index Page No—'lilLL <br />Inspected By <br />Segment No.Contract No.Upstream Downstream <br />TWO WORKING DAYS BEFORE YOU DIG. CALI UTILITY ONE-CALL SERVICE AT 1-800-332-2344 <br />\ <br />23' <br />28'S" <br />~L <br />>8 'M-V <br />\ 1 ^I <br />// <br />V <br />31' <br />22173«nt| <br />oa\i <br />•LJ