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NOTICE OF RESTRICTION OF USE <br />and Notice o Right to Appeal <br />DATE: 5-- 317M TIME 1 CASE #: <br />v - _ <br />--------- --- _ <br />LOCATION (PARK/OPEN SPACE). W <br />—, _1 - — -- — ------ ----------- <br />The basis for this N otice of Restriction of U se is that on - 3 17 1 1 You violated Section I!) ° the Park <br />t o i I - 0 <br />and Open Space Rules, and/or Section of the E ugene 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 t d <br />If you enter in or use arty 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 fa, an <br />infbi hearing coast be niade in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />within 48 hours (exclusive ofvseekends) 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 info al 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 testiniony, from the info tai hearing. <br />This Notice shall rernain 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 tune shown above by: <br />-------------- <br />(Signature of person person isquing/del 1 v o ring noti ce) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above, <br />(Signature of pe_rso <br />ng issued the notice) <br />White Copy, Public Wmks Green copy: File Y el low COPY! Repirt Copy Pink Copy Recipjcnt Gold Copyc Of1wx!r Appeal rlodee Rev 04!03 <br />`*dank: Last First Middle <br />" <br />DOB <br />qq-q-io <br />Race/sex: <br />Res- Address <br />' I �1 <br />State <br />OYQZ_ <br />Z_ <br />41iff <br />Res, Ph011e <br />Work Phone� <br />The basis for this N otice of Restriction of U se is that on - 3 17 1 1 You violated Section I!) ° the Park <br />t o i I - 0 <br />and Open Space Rules, and/or Section of the E ugene 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 t d <br />If you enter in or use arty 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 fa, an <br />infbi hearing coast be niade in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />within 48 hours (exclusive ofvseekends) 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 info al 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 testiniony, from the info tai hearing. <br />This Notice shall rernain 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 tune shown above by: <br />-------------- <br />(Signature of person person isquing/del 1 v o ring noti ce) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above, <br />(Signature of pe_rso <br />ng issued the notice) <br />White Copy, Public Wmks Green copy: File Y el low COPY! Repirt Copy Pink Copy Recipjcnt Gold Copyc Of1wx!r Appeal rlodee Rev 04!03 <br />