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NOTICE OF RESTRICTION OF USE
<br />and Notice of Right to Appeal
<br />DATE: TIME: kv-, CASE
<br />1 -11-c�
<br />LOCATION (PARKIOPEN SPACE): S/4'jAfZ-70,0J/ ',
<br />illli'il!! Fill , ppi�glpq ppi� I pli I p 11 111�1 III jl�l� �! Ir
<br />;*- Entering in or using all City of Eugene parks, open spaces or facilities.
<br />*1
<br />The basis for this Notice of Restriction off Ise is that on -2AIAL-4--, you violated Section L, -V A a 6LY f the Park
<br />and Open Space Rules, and/or Section Iq - of -- 5 —0 of the Eugene Code, 197 1, and/or ORS To wit, you.
<br />7
<br />(Description of the violation.,)
<br />- 7/WAI s
<br />This restriction of use is effective beginning on and s hall rem ain 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 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 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 testimony, from the infornial hearing.
<br />This Notice shall remain in effect pending any reqnested hearing.
<br />This Noti cc o Ex el usion was del ivered to the person named at t he top o this N otice at the date and ti me shown above by:
<br />Signature - ) -- f
<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 />White C opy: P A I i w woflts Gn ncopy_ riw Yfliew Copy: Report COPY Pink CtTy: Reciplenk GoIld Copy Offi Appeal nut i cc Rev, 04?03
<br />Nanje Last First Middle
<br />DO):
<br />Race `'rev;
<br />Y 4171
<br />Re Address: city
<br />State
<br />Zip
<br />Re& Phone:
<br />Work Phone:
<br />illli'il!! Fill , ppi�glpq ppi� I pli I p 11 111�1 III jl�l� �! Ir
<br />;*- Entering in or using all City of Eugene parks, open spaces or facilities.
<br />*1
<br />The basis for this Notice of Restriction off Ise is that on -2AIAL-4--, you violated Section L, -V A a 6LY f the Park
<br />and Open Space Rules, and/or Section Iq - of -- 5 —0 of the Eugene Code, 197 1, and/or ORS To wit, you.
<br />7
<br />(Description of the violation.,)
<br />- 7/WAI s
<br />This restriction of use is effective beginning on and s hall rem ain 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 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 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 testimony, from the infornial hearing.
<br />This Notice shall remain in effect pending any reqnested hearing.
<br />This Noti cc o Ex el usion was del ivered to the person named at t he top o this N otice at the date and ti me shown above by:
<br />Signature - ) -- f
<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 />White C opy: P A I i w woflts Gn ncopy_ riw Yfliew Copy: Report COPY Pink CtTy: Reciplenk GoIld Copy Offi Appeal nut i cc Rev, 04?03
<br />
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