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I <br /> THE SCIENCE FACTORY 1397 <br /> 2300 LEO HARRIS PKWY <br /> EUGENE,OR 97401 <br /> DATE <br /> 17 rI- I rl-f 2,bite 96-229/1232 <br /> PAY <br /> TO THEORDER V � Ti V I- �L G i\s1-{0 <br /> /�. (`DC7 <br /> ORDER OF L/ <br /> flo�h/' Gt(/L �© A(� p - �______ DOLLARS el .:S.Y.'. <br /> SOO <br /> SIUSLAW www.siuslawbank.com <br /> FOR ;oIt�Kycrot 1 1A&e, lVeow —V o W 1 k► , / ���� <br /> ) I i , <br /> City of Eugene <br /> Public Works Parks and Open Space a.x« <br /> 1820 Roosevelt Boulevard <br /> Eugene,OR 97402 <br /> Park Reservation Receipt <br /> Name of Event: 2080 1) 0 Se et'CC F�- <br /> rti <br /> Date(s) of Event: as Atlif- 'Y• �lJ <br /> • Park Location: A( 1 <br /> • <br /> Standard Use Permit o $15.00 o $30.00 $ <br /> 1 Special Use Permit a.l(0.00 o $80.00 $ (40. <br /> o Alton Baker Park Shelter#1 $ <br /> o Alton Baker Park Shelter#2 $ <br />) 0 Alton Baker Turf Area# $$ <br /> o Hendricks Park Shelter $ <br /> o Owen Rose Garden <br /> o Owen Rose Garden Chairs (optional) $ <br /> a Washington Jefferson Park $ <br /> o Other Facility Fee <br /> o Bike Path Walk/Run/Bike Event Fee $ <br /> o Vehicle Access Permit o $10.00 o $25.00 $ <br /> • <br /> 0 Event Security Deposit <br /> Fee(s) 1�C;heck#1- ❑ Cash $ u 0 . 0 <br /> Deposit(s) o Check# ❑ Cash $' Li / i <br /> Total $ 'J•• <br />