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PACIFIC RECYCLING,INC. <br /> 29381 <br /> City of Eugene—Public Works <br /> Parks and Open Space _N <br /> 1820 Roosevelt Blvd. <br /> Eugene,OR 97402 <br /> Ph: (541)682-4800 Eugene <br /> Fax: (54 11 682-4882 <br /> RECEIPT <br /> / ' <br /> Date: 'tel l y / /�� J R556 <br /> Name: Lets do. cyy'> nl " t <br /> Quantity Description I Pee: Circle One <br /> Standard Use Permit Application Fee (Non-Refundable) I $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 / $25 <br /> Other Fees <br /> Pa-14Y <br /> L1 2/y( re- _icy 7/ $10 �J <br /> Fa t�7 �/ TOTAL $ // �� <br /> Payment: C Cash /ec►k�#/�3 L �q�-1 C Credit Card j <br /> Received by: �1/4 i r IJLSLU.Y.4L� <br /> r c <br />