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notified that you are prohibited from (check box): <br />V Entering in or using all City of Eugene parks, open spaces or facilities. <br />IN <br />The basis for this N oti ce of Restriction of Use is that on you violated Section I DIII 11 f the Park <br />0- 0 <br />and Open Space Rules, and/or Section of the Eugene Code, 1971, and/or ORS To wit, you <br />(Description of violation.) <br />This restriction of use is effective beginning on 00 and shall remain In effect untilb 3 L91 _q_ <br />Ifyou 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, Areq nest fair an <br />info al hearing must be made in writing and filed with the Parks, & Open Space Division Director ("the Division Director") <br />within 48 hours (exclusive of weekrends-) of receipt of this Notice at the following address: 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />The Divisoon Director shall schedule a time and place for the infortual 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 horn 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, frorn the infon-nal 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 />1 �11 <br />(Signature o person uing/deliverin notice) g <br />� , � -Yyat nlr-r isq <br />-lcll <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />(Signature o person being issued the notice) <br />Mole Copy: Public Worb Green Cop : File Yellow Copy! Rep yt Copy Pink Copy: Recipient Gold Copy Officer Appeal no ice Rev, 04MO <br />Mnie, kast Middle <br />B: <br />C �, <br />e_/ <br />e- <br />XI <br />b 51 <br />ID�01 <br />��R <br />� VVI <br />Um <br />Res- Address: <br />state <br />Zip <br />Res, Mime: <br />Work Phone: <br />notified that you are prohibited from (check box): <br />V Entering in or using all City of Eugene parks, open spaces or facilities. <br />IN <br />The basis for this N oti ce of Restriction of Use is that on you violated Section I DIII 11 f the Park <br />0- 0 <br />and Open Space Rules, and/or Section of the Eugene Code, 1971, and/or ORS To wit, you <br />(Description of violation.) <br />This restriction of use is effective beginning on 00 and shall remain In effect untilb 3 L91 _q_ <br />Ifyou 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, Areq nest fair an <br />info al hearing must be made in writing and filed with the Parks, & Open Space Division Director ("the Division Director") <br />within 48 hours (exclusive of weekrends-) of receipt of this Notice at the following address: 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />The Divisoon Director shall schedule a time and place for the infortual 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 horn 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, frorn the infon-nal 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 />1 �11 <br />(Signature o person uing/deliverin notice) g <br />� , � -Yyat nlr-r isq <br />-lcll <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />(Signature o person being issued the notice) <br />Mole Copy: Public Worb Green Cop : File Yellow Copy! Rep yt Copy Pink Copy: Recipient Gold Copy Officer Appeal no ice Rev, 04MO <br />