& , i City of Eugene of4 <br /> Public Works Parks and Open Space w+ : <br /> 1820 Roosevelt Boulevard <br /> # _ Eugene, OR 97402A-di_a, <br /> ," °- <br /> , Park Reservation Receipt <br /> Name of Event: Pol. 19(,, <br /> , (!y , <br /> • <br /> Date(s) of Event: <br /> Gp <br /> Park Location: <br /> Standard Use Permit ❑ $1,5.00 ❑ $30.00 $ <br /> Special Use Permit ❑'$40.00 ❑ $80.00 $ LID ® � <br /> ❑ Alton Baker Park Shelter#1 $ <br /> ❑ Alton Baker Park Shelter#2 $ <br /> ❑ Alton Baker Park Entrance Shelters $ <br /> ❑ Alton Baker Turf Area # $ <br /> ❑ Hendricks Park Shelter $ <br /> ❑ Owen Rose Garden $ <br /> ❑ Owen Rose Garden with Chairs $ <br /> ❑ University Park $ i <br /> ❑ Other Facility Fee k� �6 - $ f D li- <br /> ❑ Bike Path Walk/Run/Bike Event Fee $ <br /> ❑ Vehicle Access Permit o $10.00 1 $25.00 $ 5-0 <br /> Fee(s) crtheck # ❑ Cash $ <br /> 9 'Total $ <br />