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City of,Eugene <br /> Planning & Development Department <br /> Building & Permit Services <br /> 99 W. 10th Avenue <br /> Eugene, OR 97401 <br /> Customer Information: Billing Information: <br /> C~7Y ~v~~ - Pw~ 31 ~Z~a~ <br /> Customcr NamdCompatry ate <br /> 2~f ~ . .d2~.~ w,~Y <br /> <br /> Address Purchase Order Number (non-Cary departmental <br /> ~u~, a2- y7NOc ~2J3 <br /> Clry, State, Zip Ciry Job Number or Account Code <br /> x~9s2 pw~ <br /> Cuslomer Telephone Department to be Bailed <br /> l IJ(~~i2 ~P~?~At.Fs <br /> Concoct Name <br /> Quantity Description^ofpService PIC Revenue Code Amount <br /> ~~Si ~ 81 u 3 Zt <br /> P~ L~~ ~ y 21 <br /> ~ <br /> _ Total Due <br /> <br />