i> --. <br />fl t\ <br />■» <br />Public Works <br />MaintenanceLocation of <br />Wastewater Connection 1820 Roosevelt Blvd. <br />Eugene, Oregon 97402 <br />(541) 682-4800 <br />. <br />Property Information <br />Address ;— <br />Map and Tax Lot — <br />Building Type: USED □ Duplex ’□ Multi-Family □Commercial □ Industrial <br />IZWa GfeNTUSM AvM 7 <br />Owner <br />Permit Information <br />Permit No. --Q \ pate pf Issue \<^ <br />noptmotor/Pliimhor .Pipe Material ^_Pipe Diameter <br />□ Right of Way. Cut Permit Required <br />Installation Date <br />ParvMon aranM to attach prtvata <br />□ System Development Charge • • <br />Inspected By <br />cohnactfon to.puMc nwtc In conhrmrwnc* to Cfty rtandonf* and •ptcMcaihnt. <br />[/kSJ 'Zn <br />Public Wastewater Information . <br />Index Page Flo.,— <br />l(??c.qlnspeT|S>c& <br />Segment No.1 --------- Contract No. <br />TWO WORKING DAYS BEFORE YOU DIG, CALL UTTUTY ONE-CALL SERVICE AT 1-800-332-2344 <br />l <br />>.to' <br />2'-Uk <br />\ <br />- % <br />\7~y' <br />co -6 <br />(l !e i <br />N <br />T <br />Lin-r ! <br />i H P*K-r:c <br />\i <br />I&1S2fV\A\NiY ACCfc^V ^DAD