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NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />DATE. TIME - ----------- CASE #: <br />LOCATION (PARK," OPEN SPACE),-, <br />M <br />M <br />notified, that you are prohibited from, (check box). <br />Entering in or using all City of Eugene parks, open spaces or facilities, <br />(Description of the violation.) <br />This restriction of use is effective beginning on 7 and shall remain in effect until <br />If you 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 infoTmal 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 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 testimony, from the informal hearing. <br />This Notice shall remain in effect pending any requested hearing. <br />Txis N otice of F xcl u was delivered to the person named at the top of this N oti ec, at the date and tinie shown above by: <br />_------------------- <br />(sirg2na auof person issuing/delivcring notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />(Signature of person being issued the notice) <br />While Copy: PAHL Mfork� Grem Copy: File Yellow Copy� kcpun Copy fink Copy: Rmptent Gold Copy: Officei Appc,d Rm (W03 <br />aal 1t® <br />ffi?_N <br />D013: <br />Racc <br />Rs i lk <br />�Q <br />Res. Address: ' City <br />1 zi <br />Stale <br />Zip <br />Res, Phone� <br />Work Phone: <br />notified, that you are prohibited from, (check box). <br />Entering in or using all City of Eugene parks, open spaces or facilities, <br />(Description of the violation.) <br />This restriction of use is effective beginning on 7 and shall remain in effect until <br />If you 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 infoTmal 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 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 testimony, from the informal hearing. <br />This Notice shall remain in effect pending any requested hearing. <br />Txis N otice of F xcl u was delivered to the person named at the top of this N oti ec, at the date and tinie shown above by: <br />_------------------- <br />(sirg2na auof person issuing/delivcring notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />(Signature of person being issued the notice) <br />While Copy: PAHL Mfork� Grem Copy: File Yellow Copy� kcpun Copy fink Copy: Rmptent Gold Copy: Officei Appc,d Rm (W03 <br />