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City of Eugene <br /> ity of Eugene Public Public Works Parks and Open Space /t,,� <br /> 320ut.iiWorks Parks and Open Space 4 1820 Roosevelt Boulevard t3�RCT <br /> 320 Roosevelt Boulevard tger(e <br /> Eugene,OR 97402 <br /> ugene, OR 97402 <br /> Park Reservation Receipt <br /> Park Reservation Receipt n <br /> Name of Event: 2 Vt.n2tet r\ (�/-6 Ac>r <br /> ame of Event: i ?picd--)...e, i r��11e 0 i2.1 <br /> ate(s) of Event: St(t h /14U Date(s) of Event: <br /> ark Location: <br /> N-e, Park Location: 1CleAtd • <br /> tandard Use Permit x$15.00 o $30.00 $ 15 Standard Use Permit t 5.00 c $30.00 $ 15 <br /> Special Use Permit o $40.00 o $80.00 S <br /> pedal Use Permit c $40.00 c $80.00 $ <br /> Alton Baker Park Shelter#1 $ c Alton Baker Park Shelter#1 $____ <br /> Alton Baker Park Shelter #2 $ c Alton Baker Park Shelter#2 $ <br /> Alton Baker Park Entrance Shelters $ c Mon Baker Park Entrance Shelters S <br /> Alton Baker Turf Area # S <br /> Alton Baker Turf Area # $ c Hendricks Park Shelter $ <br /> Itendricks Park Shelter $� _ Owen Rose Garden $ <br /> Owen Rose Garden $ c Owen Rose Garden with Chairs $ <br /> Owen Rose Garden with Chairs $ c University Park $ <br /> University Park $ o Other Facility Fee $ <br /> Other Facility Fee $ o Bike Path Walk/Run/Bike Event Fee S <br /> Bike Path Walk/Run/Bike Event Fee $ c Vehicle Access Permit c $10.00 o $25.00 $ <br /> Vehicle Access Permit c $10.00 o $25.00 $ <br /> :e(s) . Check # / 5 3l o Cash $ <br /> /,� Total $ <br /> Fee(s) c Check # sh $ S- <br /> Total $ i / l ` ^ � �• <br /> ., J <br /> Ph: (541)682-4800 Eugene k C <br /> Fax: (541)682-4882 <br /> I he <br /> RECEIPT <br /> Date: l a11/a I r' <br /> Name: K)WI 0 y(• kof <br /> Quantity Description I Fee: Circle One <br /> Standard Use Permit Application Fee (Non-Refundable) I $15 / $30 <br /> Special Use Permit Application Fee (Non-Refundable) I $40 / $80 <br /> Facility Fee or General Use Fee 1 $ <br /> Security Deposit Fee (Refundable) $150 <br /> ( Vehicle Access Permit Fee $10 / <br /> �C $25 Other Fees $ <br /> \�� f TOTAL $ <br /> N1' Payment: "Cash : Check# Credit Card I <br /> Received by: ‘--K 1 <br />