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- CHECK REQUEST <br /> I? <br /> Date Check Needed: A ril 2008 ~ CAN ~ ED-PWA <br /> pArE: <br /> ir.,:. ~ s:___ _ <br /> Mail Check ?XX Hand Carry Check ? <br /> <br /> General Description: Survey Filing Fee 1~ <br /> Dept. Contact: Lloyd Williams ext. 2679 y ~ , ~~V~~~ 1`I I <br /> ~d ~ <br /> Vendor Name: Lane County Surveyor's Office a,I ~j~~o~ <br /> Address: 125 E. 8~' Avenue ``[C <br /> `~~~'/o ~ <br /> City/State: Eugene, OR Zip 97401 <br /> Phone: N/A Tax ID for 1099: N/A <br /> Prepay ? Emergency X? Separate Check X? Route to: Lloyd Williams PWE-P <br /> Line Amount 800.00 <br /> Line Description: From Parks SDC funds, per Carolyn Weiss <br /> Date: 4/04/08 Requested by: Lloyd Williams <br /> Commodity # - ORDER # - <br /> ~o <br /> Line Account Codes 33~ X)CXXX 9p 5102 $ <br /> XX)OCX $ <br /> Notes <br /> PWA-LRE c:\user\forms\property.frm 4/13/95 <br /> ~ ~Z S <br /> ~ <br /> b <br /> <br />