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City of Eugene <br /> City of Eugene' ,, Public Vyirks Parks and Open Space <br /> Public Works Parks and Open Space ;,s`•, 1820 RSOsevelt Boulevard g-- <br /> 1820 Roosevelt Boulevard r Ate-. -d Eugene,OR 97402 •_ <br /> Eugene,OR 97402 •a'tr4<;-7 <br /> Park Reservation Receipt c <br /> Park Reservation Receipt <br /> �;' Name of Event: <, ttx( of(, f„Name of Event: a : ',•,. f):cLf+ r�1�:;>"11 -- Date(s) of Event: v`�"'Dates) of Event: >? j -: Park Location: iGko <br /> Park Location: ., i <br /> Standard Use Permit❑ $15.00 0 $30.00 $ ¢'+ Standard Use Permit 2r5.00 o $30.00 $ (.5. <br /> Special Use Permit o $40.00 ❑ $80.00 $ <br /> Special Use Permit o $40.00 o $80.00 $ ------------- <br /> _____,_–____—____--_— -------- o Alton Baker Park Shelter#1 $ <br /> 04ton Baker Park Shelter#1 $ r'3 ..-- <br /> a Alton Baker Park Shelter#2 $ <br />!, a Alton Baker Park Shelter#2 $ a Aron Baker Turf Area# <br /> a Alton Baker Turf Area# $ ynendricks Park Shelter $ -I r ".----- <br /> 2 Hendricks Park Shelter $ a Owen Rose Garden $ <br /> a Owen Rose Garden $ a Owen Rose Garden with Chairs $ <br /> a Owen Rose Garden with Chairs $ a Washington Jefferson Park <br /> a Washington Jefferson Park a Other Facility Fee <br /> D Other Facility Fee $ a Bike Path Walk/Run/Bike Event Fee $ <br /> 2 Bike Path Walk/Run/Bike Event Fee $ a Vehicle Access Permit❑ $10.00 o $25.00 $ <br /> 3 Vehicle Access Permit 0 $10.00 0 $25.00 $ a Event Security Deposit $ <br /> 3 Event Security Deposit $ .--_–------------------------- _ _ __ <br /> =ee(s) 0-Check# ❑ Cash $ t ���. ' Deposit(s)s(s) check# a�' o Cash $ � <br /> Deposit(s) a Check# o Cash $ <br /> p ( ) a Cash $ <br /> Total $ J /� Total $ 1V. <br /> City of Eugene <br /> Public Works Maintenance <br /> t Public Works Parks and Open Space 04.44116.N. <br /> 1820 Roosevelt Boulevard ._rte, <br /> Eugene, OR 97402 <br /> Tele # (541) 682-4800 Eugene <br /> Fax # (541) 682-4882 <br /> / (,. RECEIPT <br /> Date -36' I v <br /> From ,41._ kr <br /> Address r )/ S ka)16L; kc Cly <br /> City/State/Zip <br /> Quantity Description r Amount <br /> I (;- <br /> i-(161 - ll'>�z r I utieivtd- .t5--O. ---- <br /> i <br /> iii- 1 <br /> t5O - <br /> 1 1-01., ikAtik # co-/ <br /> TOTAL 11 5 <br /> Ci t <br /> Payment: 0 Cash „2.<heck# / 5'3 0 Credit Card <br /> , <br /> AA4A.Li Received by (11 CC Li----- <br />