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City of E M e <br />Public Worntenance <br />Public Works Parks and Open Space <br />1820 Roosevelt Boulevard <br />Eugene, OR 97402 <br />Telephone # (541) 682 -4800 <br />RECEIPT <br />Date <br />From <br />Address <br />City/State/Zip <br />Q uantity <br />Description <br />Amount <br />TOTAL <br />Internal Use <br />Payment: ❑Cash DCheck # ❑Credit Card <br />Received by <br />