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�51��3ati <br />DATE :-cM5�fi TIME: - I S I CASE L4 — (,I S�l <br />LOCATION (PARKJOPEN SPACE): C LCJk <br />1 0.00, W� <br />Entering in or using all City of Eugene parks, open spaces or facilities. <br />The basis for this Notice of Restriction of Use is that on 6 you violated Section <br />l raft e Park <br />and Open Space Rules, and/or Section -- of the Eugene Code, 1971, and/or ORS To wit, you:_ <br />(Description of the violation.) <br />This restriction of use is effective beginning on and shall remain in effect until — o c 5l <br />If you enter in or use any City of Eugene park, open space or facility during the effective period of this Notice, you may be <br />arrested and charged with criminal trespass in the second degree. <br />Pursuant to Park and Open Space Rule R-1,074 you are entitled to an informal hearing to contest this Notice. A request for an <br />infon hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />within 48 hours (exclusive of weekends) 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 informal 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 informal 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 />!�-4 (Signature of person iss ing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />(Signature of person being issued the notice) <br />White Copy: Public Works Green Copy: File Yellow Copy: Rep4irt Copy Pink Copy. Recipient Gold Copy: Officer Appeal notice Rev. 044th <br />Name: Last First Middle <br />DOB: <br />Race/Se.: <br />z <br />L <br />Res. Address: City <br />State <br />Zip <br />Res. Phone: <br />Work- Phone: <br />1 0.00, W� <br />Entering in or using all City of Eugene parks, open spaces or facilities. <br />The basis for this Notice of Restriction of Use is that on 6 you violated Section <br />l raft e Park <br />and Open Space Rules, and/or Section -- of the Eugene Code, 1971, and/or ORS To wit, you:_ <br />(Description of the violation.) <br />This restriction of use is effective beginning on and shall remain in effect until — o c 5l <br />If you enter in or use any City of Eugene park, open space or facility during the effective period of this Notice, you may be <br />arrested and charged with criminal trespass in the second degree. <br />Pursuant to Park and Open Space Rule R-1,074 you are entitled to an informal hearing to contest this Notice. A request for an <br />infon hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />within 48 hours (exclusive of weekends) 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 informal 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 informal 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 />!�-4 (Signature of person iss ing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />(Signature of person being issued the notice) <br />White Copy: Public Works Green Copy: File Yellow Copy: Rep4irt Copy Pink Copy. Recipient Gold Copy: Officer Appeal notice Rev. 044th <br />