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DATE; <br />WnCE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />TIME: CASE d <br />Ma <br />LOCATION WARKJOPEN SPACE): <br />I0 Futering in or using all City of Eugene parks, open spaces or facilities. <br />El <br />The basis for this Notice of Restriction of Use is that on you violated Section the Park <br />and Open Space Rules, and/or Section of the Eugene Code, 1971, an4lor ORS To wit, you: <br />Ad 0 " Crl" <br />Pursuant to Park and Open Space Rule R-1.074 you are entitled to an infiannal hearing to contest this Notice. A request for an <br />informal hearing must be made in writing and filed with the Park-, & Open Space Division Director ('!be Division Director") <br />within 48 hours (exclusive ofweekends) of receipt of this Notice at the following address: 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />The Division Director shall schedule a time and place for the infm hearing to be conducted, which shall be not more than <br />72 hours (exclusive of weekends) of receipt of the request for hearing. At the informal hearing the Division Director will only <br />consider testimony from you, City personnel involved in the incident that resulted in this Notice, and other witnesses to the <br />incident, The Division Director may exclude anyone, other than you and those presenting testimony, from the infor hearing. <br />This Notice shall remain in effect pending any requested hearing. <br />This Notice of Exclusion was delivered to the person named at the top of this Notice at the date and time shown above by <br />6q6 <br />(Signature ofperson issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />CI <br />(Signature of person being issued the notice) <br />L i ( C, <br />WhitQ Coiw Public WkAs Green Copy: File Yellow Cot. Report Copy Pink Copy: Recipient G old Copy: 0 M c (�r Appca I no H c v Rcv- 04,03 <br />Nanwz Lasl First Middle <br />1)013_ <br />Race <br />blff <br />U ( 'Al <br />Res, Address City <br />State <br />Zip <br />Res, Phone: <br />Work Phone� <br />Ai <br />lit A <br />I0 Futering in or using all City of Eugene parks, open spaces or facilities. <br />El <br />The basis for this Notice of Restriction of Use is that on you violated Section the Park <br />and Open Space Rules, and/or Section of the Eugene Code, 1971, an4lor ORS To wit, you: <br />Ad 0 " Crl" <br />Pursuant to Park and Open Space Rule R-1.074 you are entitled to an infiannal hearing to contest this Notice. A request for an <br />informal hearing must be made in writing and filed with the Park-, & Open Space Division Director ('!be Division Director") <br />within 48 hours (exclusive ofweekends) of receipt of this Notice at the following address: 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />The Division Director shall schedule a time and place for the infm hearing to be conducted, which shall be not more than <br />72 hours (exclusive of weekends) of receipt of the request for hearing. At the informal hearing the Division Director will only <br />consider testimony from you, City personnel involved in the incident that resulted in this Notice, and other witnesses to the <br />incident, The Division Director may exclude anyone, other than you and those presenting testimony, from the infor hearing. <br />This Notice shall remain in effect pending any requested hearing. <br />This Notice of Exclusion was delivered to the person named at the top of this Notice at the date and time shown above by <br />6q6 <br />(Signature ofperson issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />CI <br />(Signature of person being issued the notice) <br />L i ( C, <br />WhitQ Coiw Public WkAs Green Copy: File Yellow Cot. Report Copy Pink Copy: Recipient G old Copy: 0 M c (�r Appca I no H c v Rcv- 04,03 <br />