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•• <br /> City ofagene • __;• <br /> Public Works Parks and Open Space <br /> 1820 Roosevelt Boulevard <br /> Eugene, OR 97402 <br /> Park Reservation Receipt ""�.11. <br /> Name of Event: f ,SC er z-L <br /> Date(s) of Event: (� /!J //lko U <br /> Park Location: 14Le rtdn.i'.ck Ci- €{{e • <br /> Standard Use Permit❑ $15.00 9430.00 $ <br /> Special Use Permit ❑ $40.00 ❑ $80.00 $ <br /> ❑Alton Baker Park Shelter#1 $ <br /> ❑Alton Baker Park Shelter#2 $ <br /> ❑ Alton Baker Turf Area# $ <br /> (endricks Park Shelter <br /> ❑ Owen Rose Garden $ <br /> ❑ Owen Rose Garden with Chairs $ <br /> ❑ Washington Jefferson Park <br /> ❑ Other Facility Fee $ <br /> ❑ Bike Path Walk/Run/Bike Event Fee $ <br /> ❑Vehicle Access Permit❑ $10.00 o $25.00 $ <br /> ❑ Event Security Deposit $ <br /> Fee(s) l -Check# nZ( ,0 Cash $ I OS.r <br /> Deposit(s) ❑ Check# ❑ Cash $ • <br /> Total $ !D5� <br /> 2126 <br /> JELENA RAHEL JAEHNIG <br /> 4350 DILLARD RD 96-744613232 <br /> EUGENE,OR 97405 r /,. 102 <br /> tC� ate <br /> Pay to the <br /> Order of 1 � � • <br /> 0'/ <br /> / 04 ` L lJ Dollars ' : <br /> auc a.D u w l* NICE.REMARKABLY NICE. <br /> CREDIT UNION 1 I <br /> 900.305.1111 <br /> www.Oro90.0.^"n"C"r9 , 7 <br /> NP <br /> For _____ <br /> .a,iand Cana <br />