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City of Eugene ~ /~~J ~ <br /> Planning & Development Department / <br /> Building & Permit Services <br /> 99 W. 10th Avenue ~ ~ <br /> Eugene, OR 97401 ~ ' <br /> ~ l~i~ <br /> Customer Information: ` <br /> Billing Information: <br /> Curtomsr N Comparry --T- <br /> <br /> Address ~ - - - - Purehass Order N r (non-City depardnents) <br /> rz._ 1 ~ <br /> City, Stats, ~ I City Job Number or Account Cods <br /> Customer Tskphons Departmtnt to bs B!lJsd <br /> r) C n <br /> ContactNmne ~~Y~~ . In 1 S C° ~ ~ O~~ ~ <br /> Q~~tY Description of Service PIC Revenue Code Amount <br /> ~ \U' <br /> -f- 0 4 ~ ~ <br /> CO~~ ~ <br /> ' % -'1 - l) cJ n - f ~ ~ 1 ~ Total Dui <br /> <br />