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b bb I ^n- <br />■r' <br />i . <br />I <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----i <br />Building Type: ^^SFD <br />F>ndfd (t )a\ K A 'Jt. <br />:------------------------:--------Owner <br />□ Duplex □ Multi—Family □ Commercial □ Industrial <br />Contractor/Plumber_ <br />□ Right of Way Cut Permit Required <br />Installation Date <br />PwrrMon granted to attach private <br />5^-/9 <br />Sdrs.^O <br />Date of Issue <br />Pipe MateriaL <br />□ System Development Charge <br />\~<x.CcL£>£e <br />h ccnformnanco to CXy etandardm and tpadifcathna. <br />V"He. HcbeLe.Pipe Diameter. <br />Inspected By <br />connecHoa to pubOc <br />Public Wastewater Information <br />Index Page No. <br />Inspected^ <br />T3 I'SlfcOSegment No.Contract No.Upatream Oownstream <br />TWO WORKING DAYS BEFORE YOU DIG. CALI UTILITY ONE-CALL SERVICE AT 1-800-332-2344 <br />M <br />i <br />, ^