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r. bbb <br />* 'I <br />» .«r.:- <br />i . -i <br />Public Works <br />k MaintenanceLocation of <br />Wastewater Connection 1820 Roosevelt E3lvd. <br />Eugend, Oregon 97402 <br />(541) 682-4800 > . <br />* <br />Wy information^^ <br />Map and Tax Lot___ <br />Building Type: ■ SFD <br />'■ .______ '• • . Own er <br />□ Duplex '□Multi-Family □Commercial □ Industrial- <br />\Permit Information <br />Permit No.Date of Issue I j' ^ <br />nontrngtor/Plumher Ca Co^T^ACT-Or?S■___Pipe Material Pipe Diameter_^_ <br />□ System Development, Charge , <br />Inspected By Llo^tj 1 <br />h ccnfarmnancu to CXy standard* and •ptcMcaifons. <br />□ Right of Way. Cut Permit Required <br />Installation Date _\ / 'Hr [ *Z.O------------- <br />Ptrmlniop gnjnM to attach prtvata —«r connection to putdc <br />I. <br />Public Wastewater Information.. . Inspected By <br />Segment No. 'MlPage No., ^Index Contract No.Upstream <br />TWO WORKING DAYS BEFORE YOU DIG, CALL UTILITY ONE-CALL SERVICE AT 1-800-332-2344