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vii iii cVVp rni ice: av reua wi ppc p7VV l+ru~r+ yV rn <br />.~, Lane County Department of Public Works <br />~' .I <br />N3 Facility Permit -Receipt of Payment <br />.r ' ~~+~ ~ { Lane County Public Works <br />3040 N. Delta Hwy. <br />Eugene, OR 97408 <br />(541)682-6902 <br />Road Construction <br />Permit 0$0385 Receipt Date 07/11/2008 <br />Receipt For $~' EARL STNS- GINGER PERALES j ~~ ~~~„Q-m <br />EUGENE, OR 97401 ~ (' ~, ~S~ <br />. n <br />Method of Payment Mastercard <br />Items Paid <br />Permit Fee <br />LANE COUHIV PUBIIC igRK <br />SRERRV 541.682.6916 <br />EUGEIIE~ OR. 97408-1636 <br />TERI~QNAL I.D.. 801734BOOG39D024497602 <br />MERCHRNT N• 9580144916 <br />NG PCRRD <br />~K~'i1Nit6110 t <br />SALE <br />RECORD N% 1 IHV~ 008881 <br />DRTE; JUL il, OB tilt 14;18 <br />BRTCN~ 945 <br />AUTH: 819959 <br />CUST CQDE~ lY3 <br />RUS RESPDIISE~ N <br />NO MRTCH 011 ROORESS OR 21P <br />TOTAL 5250.00 <br />I AGREE TO PAV ABDUE TD1Al Rh(OUIIT <br />RCCORDIN6 i0 CRRD ISSUER RGREEli:lli <br />tHERCNRIIi RGREEIfHT IF CREDIT VOUCHER) <br />ClIS101~R COPY <br />I~VV1/ VVi- <br />Receipt No 2908 <br /> <br />Amount Paid $250.00 ~ <br />Amount <br />Totai <br />$250.00 <br />Thank you for your payment <br />