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~3s~ <br /> ([•3.•0~ <br /> City of ~.agene <br /> Planning & Development Department <br /> Building & Permit Services <br /> 99 W. 10th Avenue <br /> Eugene, OR 97401 <br /> Customer Information: Billing Information: <br /> Gl7"Y D~ ELt~1~ x'05 _ (I~I~04 <br /> Customer Nanu/Comparry Dote <br /> ~o ~ySEV'~t-~ i3~...y f~ <br /> <br /> address Purchase Order Number (non-City deportmenu) <br /> Cfry, Swte, Zip ~ Z ( Cfry Job Number oc Account Code <br /> Customer Teltphone Deportment to be Bllled <br /> ~o~Y~ V~E1SS <br /> Contact Name <br /> Quantity Description of Service PIC Revenue Code Amount <br /> ( L.V G S of ~ <br /> ,il s ~Y Lo g.p s ~ YrP~ri<' ~ ~ ¢ $ v <br /> LPrND VSE ~MP,'tTtB14tT`( "i~-r-EMeTIT <br /> . 5 Zi 1 9-8a <br /> 3Z -cc3 S-C~,f ~~Z-~xc~5` Z32. <br /> ~ ~ ~ v <br /> Total Due <br /> <br />