Public Works <br />MaintenanceLocation of <br />Wastewater Connection 1820 Roosevelt Blvd. <br />Eugene, Oregon 97402 <br />(541) 682-4800 <br />Property Information <br />Address —:----- <br />Map and Tax Lot-----1 <br />Building Type: df SFD <br />Tr'ih'tte h )fty <br />I K ^______________:_____Owner <br />□ Duplex □ Multi-Family □ Commercial □ Industrial <br />Permit Informat on <br />Permit No. 1 ^ ~ O^IO) G '£> f__ <br />Contractor/Plumber <br />□ Right of Way Cut Permit Required <br />Installation Date -------^ ~ / <br />PtanMan grant*/ to attach prtoota <br />h&i£oDate of Issue <br />Pipe Mnt^rinl '' Pipe Diameter.H" <br />□ System Development Charge <br />La CazJieInspected By <br />to <br />Public Wastewater Information <br />Index Page No-----Jb<2?.— Segment No—xrp3treornto Contract No.LK>wn3tream <br />TWO WORKING DAYS BEFORE YOU DIG, CALL UT1UTY ONE-CALL SERVICE AT 1-800-332-2344 <br /><r-t <br />NrtissiiI <br />13 <br />*/(? Cj <br />o <br />I <br />I <br />t