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.111.1111111.1.111.1.111.11.111.1. 4111111111111.11111.11111MMINIMEMEMINIMI <br /> 1 j,....a-Xii.,4n:.1;: Mrft <br /> .K�MIMIM 31.1CC.41.n,...a1u, _. 0.1 <br /> 24-84/1230 52952262,^ <br /> O UNIVERSITY OF OREGON PO BOX 3237,EUGENE OR 97403-0237 DS THROUGH US BANK <br /> VOID <br /> 541.346.3143 VOID SIX MONTHS FROM DATE OF ISSUE <br /> DATE 09/23/16 • 11 <br /> PAY One Hundred Forty& 00/100***************************************************** ****140.00 8 <br /> ********************************************************** <br /> TO EUGENE CITY OF <br /> THE 1 <br /> ORDER CITY HALL <br /> OF PO BOX 1967 #4 "9,,,, <br /> EUGENE OR 97401 a,�FJ <br /> o- <br /> • <br /> C0y,:L J <br /> C4.of Eugene <br /> Public Works Parks and Open Space ,` V <br /> 1820 Roosevelt Boulevard �. <br /> Eugene, OR 97402 r" F.e <br /> Park Reservation Receipt <br /> Name of Event: R( .r\ w 1 pi'1�2 Duk cjfL' <br /> Date(s) of Event: 10I 3 0 I t to <br /> Park Location: P,. 13�k Q& / I'S i Y-2— �14. ) ni) <br /> Standard Use Permit❑ $,15.00 ❑ $30.00 $ <br /> Special Use Permit 040.00 o $80.00 $ 0.— <br /> o Alton Baker Park Shelter#1 $ <br /> ❑Alton Baker Park Shelter#2 $ <br /> ❑Alton Baker Turf Area# $ <br /> ❑ Hendricks Park Shelter $ <br /> 2 Owen Rose Garden $ <br /> 3 Owen Rose Garden with Chairs $ <br /> 3 Washington Jefferson Park <br /> 2 Other Facility Fee $ <br /> /Bike Path Walk/Run/Bike Event Fee $ 7 c. <br /> 'Vehicle Access Permit❑ $10.00 d$25.00 $ 2 5,— <br /> Event Security Deposit $ <br /> =ee(s) G-Check#2.2.—– o Cash $ <br /> Deposit(s) ❑ Check# ❑ Cash $ <br /> Total $ I , D .e <br />