I <br /> EPIC RELAYS 1747 <br /> 'CREATING EPIC ADVENTURES <br /> 1 10482 KETCHWOOD CT <br /> HIGHLANDS RANCH,CO 80130 Q <br /> (970)301-6130 DATE_ 51 2- °1201( 23-101-1020 • <br /> TOTHE G` ( or ? UIVll� V�+o_��� 1 $ &Or'� oO <br /> -� ORDER OF (����1 � `y�,/�� '^ �J <br /> SIX Y L l of l a ft t DOLLARS 8 See.Foam. <br /> CHASE 0 <br /> JPMorgan Chase Bank,N.A. <br /> www.Chase.com <br /> 4 A- \+vn. Pte'_- y& 11-+- <br /> FOR _---- ---______—_-2 - -- "P <br /> 1'' <br /> C-'y of Eugene <br /> Public Works Parks and Open Space ; <br /> 1820 Roosevelt Boulevard <br /> Eugene,OR 97402 <br /> Park Reservation Receipt <br /> Name of Event '• ft(i ' 'Q , <br /> Dates) of Event: /4 t ' - (b IL �l- J �9�,1,L y <br /> Park Location:------------------ <br /> Standard Use Permit❑, 15.00 o $30.00 $ <br /> Special Use Permit m40.00 o $80.00 $--- ----- <br /> ran Baker Park Shelter#1 �"d� $ s0 <br /> Iton Baker Park Shelter#2 d ""0 $�7 <br /> o Alton Baker Turf Area# $ <br /> a Hendricks Park Shelter $ <br /> o Owen Rose Garden <br /> o Owen Rose Garden Chairs(optional) $ <br /> a Washington Jefferson Park $ <br /> o Omer Facility Fee . <br /> o/SIke Path Walk/Run/Bike Event Fee $ -75- <br /> . <br /> 5- <br /> ❑Vehicle Access Permit o $10.00 a $25.00 $ <br /> o Event Security Deposit <br /> — M <br /> Fee(s) C eck# 171-17 ❑ Cash $ <br /> 4 Deposit(s) o Check# o Cash $ <br /> 1 Total $ <br />