bbW■t <br />{ <br />Public Works <br />MaintenanceLocation of <br />Wastewater Connection 1820 Roosevelt Blvd. <br />Eugend, Oregon 97402 <br />(541) 682-4800 <br />3361 KorbelProperty Information <br />Address ------_i—:— <br />Map and Tax Lot — <br />Building Type: ^"SFO □ Duplex □ Multi-Family □ Commercial □ Industrial <br />HayriptnOwner <br />Permit Information <br />Permit Kin. ^ ~ O 1 Date of Issue M~i£>~cPC ^ <br />rnntrnr-tnr/Pliimhnr f ^ Logyv^ pipe Material ^ch.ilc. Pipe Diameter^ <br />□ Right of Way Cut Permit Required <br />Installation Date —L— <br />PwmMon granted to attach prtvato <br />□ System Development Charge <br />U* (La£,S(^b-lt'2o Inspected By <br />h canformnanc* to CJty ttondardo and tpocf/lcatlont.connocVoa to puMtc <br />Public Wastewater Information <br />Index Page No. <br />Inspected By — <br />J-39^5 <br />Upstream- DownstreamSegment No.Contract No. <br />TWO WORKING DAYS BEFORE YOU DIG. CALL UTILITY ONE-CALL SERVICE AT 1-800-332-2344 t <br />W <br />% <br />It >5 <br />I <br />I <br />. :■