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NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />�T'l q2 <br />DA D <br />TIME: 12 CASE #-, <br />LOCATION (PARK/OPEN SPACE): Ase- <br />T <br />PLUNIUMi61-1 Hlil Upruer 110. 1 ace W �V mi. 1. U3�-tlp, YkjU ag <br />gotified that you are prohibited from (check box)- <br />0 <br />Entering in or using all City of Eugene park%, open spaces or facilities. <br />14 <br />The basis for this Notice of Restriction of Use is that on ' <br />t4 you viol a ted Section the 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 restrictian of use is effective beginning on and shall remain in effect until D 1 2tly <br />If you enter in Of tree 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 Pork rind Open Space Rule R-1.074 you are entitled to an informal hearing to contest this Notice. A request for an <br />informal 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 sharp 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 />Thiq Notice shall remain in effect pending any requested hearing. <br />This Notice of Exclusion was delivered to the person varied at the top of this Notice at the date and time shown above by <br />- -- ------ - - - - -- ------- - ----- <br />(Signature cat` pexson iss g/deliv notice) <br />otice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />tAmA&F T'Z:> - St4ilo! hU4Z TZ) WSTI�� <br />(signature of person being issued the notice) <br />LAC� CeF CLMPLAA� <br />white Cupy: pubfi� Works Grcop. copy File Y e I low 1"c opy; Repon C ole rink Cupy: Rlccipwnt Gol k I Copy, 0 ffic or Appeal not Ice Rev 04,03 <br />Name Last First Middle <br />D(,)13: <br />Race/Sex: <br />ASSCf A <br />Res, Address city <br />s <br />F late Zip <br />Res. Plione: <br />Work Phone: <br />T <br />PLUNIUMi61-1 Hlil Upruer 110. 1 ace W �V mi. 1. U3�-tlp, YkjU ag <br />gotified that you are prohibited from (check box)- <br />0 <br />Entering in or using all City of Eugene park%, open spaces or facilities. <br />14 <br />The basis for this Notice of Restriction of Use is that on ' <br />t4 you viol a ted Section the 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 restrictian of use is effective beginning on and shall remain in effect until D 1 2tly <br />If you enter in Of tree 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 Pork rind Open Space Rule R-1.074 you are entitled to an informal hearing to contest this Notice. A request for an <br />informal 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 sharp 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 />Thiq Notice shall remain in effect pending any requested hearing. <br />This Notice of Exclusion was delivered to the person varied at the top of this Notice at the date and time shown above by <br />- -- ------ - - - - -- ------- - ----- <br />(Signature cat` pexson iss g/deliv notice) <br />otice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />tAmA&F T'Z:> - St4ilo! hU4Z TZ) WSTI�� <br />(signature of person being issued the notice) <br />LAC� CeF CLMPLAA� <br />white Cupy: pubfi� Works Grcop. copy File Y e I low 1"c opy; Repon C ole rink Cupy: Rlccipwnt Gol k I Copy, 0 ffic or Appeal not Ice Rev 04,03 <br />