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If you enter in or use any City of Eugene park, open space or facility during the effective period of this Notice, you inav 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 infomial hearing to contest this Notice. request for an <br />infOrTnal hearing must be made in writing and filed with the Parks LIL Open Space Division Director ("the Division Director"') <br />within 48 hours (eve Ins ive of weekends) of receipt of this Notice at the followink* address.- 1820 Roosevelt, Blvd., Eugene, 0 R <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 infornial 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 testi mony, Crom the info al hearing, <br />Thi% Notice shall remain in effect pending any requoted hearing. <br />This Notice of Exclusion was delivered to the person named at the top o this N ofice at the date and time shown abovc by <br />(Sign Ide otico) <br />(Signature ol'person iSSUiT1911 - e 1!1e Ing 11 <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above, <br />- ----------------- -- -- ------------------- C� <br />(Signature of pers)n being issued the notice) <br />White Copy; Public Works Green copy: File Yellow Copy! Report Copy Pink Cupy: Rccipient 6 aL I Copy f 0 IT cer Appeal nolice Rc%, MM1 <br />Name: Last First Middle <br />DOB: <br />Race/Sex <br />�e <br />O 3 <br />1i N <br />11L� <br />Rcs..Address: city <br />State <br />Zip <br />Res. Phone. <br />Work Phone: <br />If you enter in or use any City of Eugene park, open space or facility during the effective period of this Notice, you inav 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 infomial hearing to contest this Notice. request for an <br />infOrTnal hearing must be made in writing and filed with the Parks LIL Open Space Division Director ("the Division Director"') <br />within 48 hours (eve Ins ive of weekends) of receipt of this Notice at the followink* address.- 1820 Roosevelt, Blvd., Eugene, 0 R <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 infornial 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 testi mony, Crom the info al hearing, <br />Thi% Notice shall remain in effect pending any requoted hearing. <br />This Notice of Exclusion was delivered to the person named at the top o this N ofice at the date and time shown abovc by <br />(Sign Ide otico) <br />(Signature ol'person iSSUiT1911 - e 1!1e Ing 11 <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above, <br />- ----------------- -- -- ------------------- C� <br />(Signature of pers)n being issued the notice) <br />White Copy; Public Works Green copy: File Yellow Copy! Report Copy Pink Cupy: Rccipient 6 aL I Copy f 0 IT cer Appeal nolice Rc%, MM1 <br />