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City of Eugene . <br /> Planaing & Development Department <br /> Building & Permit Services <br /> 99 W. 10th Avenue <br /> Eugene, OR 97401 <br /> Customer Information: Billing Information• <br /> ~ ~ ~ o~ <br /> Custonur N conparry+ rite <br /> ~t o C` .P~ ~ r-e ~ ~ <br /> <br /> A~ Pwclrass ortkr Numbsr (non-Cry departments) <br /> ~ 6~2 ~17~ 1 ~',~c4 ~ b <br /> Ctry, Sorts. Zr Ctry Job Number or dccount Code <br /> Customsr T~kphone Department to be Brikd ' <br /> Co+uact Name <br /> Quantity Description of Service PIC Revenue Code Amount <br /> r ~ ~~i~ s.~ <br /> Co ~ 2- <br /> Total Due <br /> <br />