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• <br /> DONALD R FURTICK TSTEE GANT 71-22/12:30 3247 <br /> • THE DONALD R FURTICK AND <br /> LIVING TRUST <br /> 790 LORANE HWY. <br /> EUGENE,OR 97405-2340 DATE <br /> RATTOTkIDOR ' r, Dom— ,,rXa $ SSG <br /> The Private Client Group <br /> Cibank. <br /> sr a - <br /> o .111173/ <br /> t; <br /> • <br /> DONALD R F(.'RI ICK TSTEE GRNT 24-nh1 3246 <br /> • THE DONALD R FURTICK AND <br /> LIVLNG TRUST DATE <br /> 790 LORANE HWY. <br /> EUGENE.OR 97405-2740 /�v7 ,.) <br /> t •1�•y C/� Uj.dl'et+ $ /0104 - <br /> PATTOT EORDFE&G* �- <br /> Ul+ti r`s++f 1 aI'lO - — DOLLARS 8 =.. <br /> 3 The Private Client Group <br /> [ibank. <br /> MEMO <br /> �12atoo - 5-0 - - <br /> City of Eugene-Public Works <br /> Parks and Open Space <br /> 1820 Roosevelt Blvd. `�. ,n•Lf r l�" <br /> Eugene,OR 97402 Eugene lJ(. <br /> Ph: (541)(54682.4 80 Pactri <br /> Fax: (541)682-4882 'n� <br /> -.71)//r..11 <br /> RECEIPT .. iiPICI1' <br /> Date: r� I C Al4 u i /_'l rt \ ,�1 Zf . U3 7 <br /> Name: Coil rieknh.a l✓tC( ci �i./' ) g" L� SCA) <br /> Quantity Description 1 Fee: Circle One <br /> Standard Use Permit Application Fee (Non-Refundable) $15 / $30 <br /> Special Use Permit Application Fee (Non-Refundable) $40 / $80 <br /> Facility Fee or General Use Fee $ <br /> Security Deposit Fee (Refundable) $150 <br /> Vehicle Access Permit Fee $10 / $25 <br /> Other Fees CetA pi 4-rf 2 4 of $ 4c C. •` <br /> TOTAL $ -r - u <br /> e 3141 ( s 3cC <br /> Payment: - Cash r 2Check#3 L L ( I IL.b) Z Credit Card <br /> Received by: �� <br />