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Public Works <br />MaintenanceLocation of <br />Wastewater Connection 1820 Roosevelt Blvd. <br />Eugen6, Oregon 97402 <br />(541) 682-4800 <br />-fchProperty Information <br />Address •____ <br />Map and Tax Lot — <br />Building Type: <br />1908 E. Vq^Av/<“. <br />oWreOwner <br />□ Duplex □ Multi-Family □ Commercial □ Industrial <br />Permit Information <br />Permit No. <br />e:nnfrnrtr>r/Pliimhfir Plumb- Pipe Material HL V u <br />□ Right of Way Cut Permit Required <br />Installation Date __£>~^Q~ -------- <br />Pwrmhtkrn omnM to ottocti pftvotm mmt coonoetioo to pMc —w h conformnanco to CXy otandonh and ycdfartfawL <br />IS-03667-01 5^-99-17Date of Issue / / <br />Pipe Diameter^! <br />□ System Development Charge <br />Inspected By -----^ <br />Public Wastewater Information <br />Index Page No—1 H C Segment No.Contract No.Downstroom <br />TWO WORKING DAYS BEFORE YOU DIG. CALI UTTUTY ONE-CALL SERVICE AT 1-800-3J2-2344 <br />pipe taor^t-■r -tA <br />Ai •i <br />56W.HO to <br />7- <br />0 <br />a) <br />•>