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City of Eugene Public Works Maintenance M _ Public Works Parks and Open Space 1820 Roosevelt Boulevard �,�•.11111r Eugene, OR 97402 Tele # (541) 682-4800 Eugene Fax# (541) 682-4882 II RECEIPT Date . - 1. /(7 From � j'L� 6(1/TIL__... 1hAddress � � City/State/Zip Quantity Description Amount / Ft -. kua A-cce s G PAM ri '/6 .— TOTAL I Q Payment: -C Cash 0 Check# 0 Credit Card Received by Sktth Al c lifAJ - City of Eugene City of Eugene :�7"- ". Public Works Parks and Open Space �`•= PutLic Works Parks and Open Space r 1820 Roosevelt Boulevard. _ 1820 Roosevelt Boulevard ' Eugene,OR 97402 "r Eugene, OR 97402 Park Reservation Receipt Park Reservation Receipt ,, QQ Name of Event: Sh rQ 4 Pte. AguL Gde Name of Event: .5.1,12.d f 11,16t4.5 I4)eaeukt- Date(s) of Event: Z. /' Date(s) of Event: 5- co -I 14o Park Location: 14-e/11.4L I.IG$ ark Location: t'Lenctni Ck 5 SkC-0-4{ -------------------------- - --- Standard Use Permit 15.00 ❑ $30.00 $ 11/45. Standard Use Permit ❑15.00 o $30.00 $ i5.— Special .Special Use Permit ❑ $40.00 o $80.00 $ Special Use Permit o $40.00 o $80.00 $-------------- _- ❑Alton Baker Park Shelter#1 $ Alton Baker Park Shelter#1 $ ❑Alton Baker Park Shelter#2 $ ) Alton Baker Park Shelter#2 $ ❑Aler�t n Baker Turf Area# $ i A on Baker Turf Area# $ a'F endricks Park Shelter $ 75. endricks Park Shelter $ ❑ Owen Rose Garden $ ) Owen Rose Garden $ ❑ Owen Rose Garden with Chairs $ ) Owen Rose Garden with Chairs $ o Washington Jefferson Park )Washington Jefferson Park o Other Facility Fee $ i Other Facility Fee $ o Bike Path Walk/Run/Bike Event Fee $ i Bike Path Walk/Run/Bike Event Fee $ o Vehicle Access Permit❑ $10.00 ❑ $25.00 $ Vehicle Access Permit❑ $10.00 ❑ $25.00 $ o Event Security Deposit $ 1 Event Security Deposit $ Fee(s) a-Check# Vt ❑ Cash $ ee(s) /Check# a.O83 o Cash $ '70. Deposit(s) ❑ Check# ❑ Cash $ eposit(s) o Check# o Cash $ V5&A� Total $ CiV•• / Total $ ` V'