_ <br />Method of Payment FCustorner Information <br />❑ Cash Name Bill Kloos <br />Check Address <br />❑ Visa/MC <br />Pr1 oject Appeal of PDT 17-1 <br />Amount Received <br />$8,845.35 - ❑ City/Government Agency <br />Staff Receiving Application <br />MHD i <br /> <br />99 West 10th Avenue • Eugene, Oregon • 97401 ® 541-682-5377 • eugeneplan <br />