NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />DATE: TIME: CASE #- <br />LOCATION (PARK/OPEN SPACE): <br />. ........... . . . . . . — - ----- <br />The basis for this Notice of Restriction of Use is that on you violated Section zAe10&100f the Park <br />(Description of the violation.) <br />This restriction of use is effective beginning on /—, and shall remain in effect until <br />I f you enter in or use any C ity o Eugene park, open space or facility during the effective period o this Notice, you Ynay 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 Notiec. X request for art <br />infornial hearing Must bC, made in writing and filed with the Parks & Open Space Division Director ("the Division Director <br />within 49 hours (exclusive of weekends) of receipt of this Notice at the following address. 1,924) Roosevelt, Blvd., Eugene, OR <br />97402. <br />The Division Director shal schedul a time and place for the in formal h earing to be con dusted, which sha be not more to arl <br />72 hours (exclusive of weekends) of receipt of the request for hearing. At the in fio hearing the Di v isi on D irector gi only <br />consider testimony from you, City personnel involved in the incident that requited 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 />(Signature of person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and Time indicated above. <br />- - - — - ------------- <br />(SigDatUre of person being issued the notice) <br />Whilcr Copy Public Workc Gmcn Cupy: Fi]4, Yellow cory� Rgepun Copy Nnk Copyc Re Jpient G ol d Copy - 0 Meer Appeal notice Rv,, 04103 <br />Name: Last First Middle <br />D OB <br />Z . ...... .. <br />Race/Sex: <br />hz <br />Res- Address: city <br />State <br />Zip <br />Res, Phone <br />Work Phone" <br />The basis for this Notice of Restriction of Use is that on you violated Section zAe10&100f the Park <br />(Description of the violation.) <br />This restriction of use is effective beginning on /—, and shall remain in effect until <br />I f you enter in or use any C ity o Eugene park, open space or facility during the effective period o this Notice, you Ynay 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 Notiec. X request for art <br />infornial hearing Must bC, made in writing and filed with the Parks & Open Space Division Director ("the Division Director <br />within 49 hours (exclusive of weekends) of receipt of this Notice at the following address. 1,924) Roosevelt, Blvd., Eugene, OR <br />97402. <br />The Division Director shal schedul a time and place for the in formal h earing to be con dusted, which sha be not more to arl <br />72 hours (exclusive of weekends) of receipt of the request for hearing. At the in fio hearing the Di v isi on D irector gi only <br />consider testimony from you, City personnel involved in the incident that requited 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 />(Signature of person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and Time indicated above. <br />- - - — - ------------- <br />(SigDatUre of person being issued the notice) <br />Whilcr Copy Public Workc Gmcn Cupy: Fi]4, Yellow cory� Rgepun Copy Nnk Copyc Re Jpient G ol d Copy - 0 Meer Appeal notice Rv,, 04103 <br />