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notified that you are prohibited frorn (check box): <br />The basis for this Notice of Restriction o Use is that on 7ji 7 _, you violatedSeetiooI C 4) <br />- f-2 , io I fthe Park <br />_o <br />and Open Space Rules, andJor Section of the Eugene Code, 1971, andJor ORS To wit, yowl�q�, <br />(Description of the violation.) <br />and shall remain in effect until <br />This restriction of use is effective beginning on ikuh*—, <br />If you eater in or use any City of Eugene park, open space or facitity 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 - 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 Rorer vela, Blvd., Eugene, Cl <br />97402, <br />The Division Director shall schedule a ti a.nd place for the informal hearing to be conducted, which shall be not more than <br />72 hours ( exclusive 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 />This Notice of Exclusion was delivered to the person named at the top of this Notice at the date and tirne shown above by: <br />(Signatu.;� fice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />� n <br />Wi aturc of per. oil 'b ing issued the n tic el <br />White Copy: Pub is Woiks Gmen Copy: File Yellow Copy: Report Copy Pink Copy: Rc6pivyll G Copw 0— fficer A ppeal nofice Rev, 04103 <br />Nance Last First %Me <br />DOB� <br />Racv/sex -, <br />P' 7- <br />cit� <br />citv <br />�tes. Addr I <br />I s. A <br />State <br />Zip <br />zip <br />Res. Phon t: <br />Work Phon e: <br />notified that you are prohibited frorn (check box): <br />The basis for this Notice of Restriction o Use is that on 7ji 7 _, you violatedSeetiooI C 4) <br />- f-2 , io I fthe Park <br />_o <br />and Open Space Rules, andJor Section of the Eugene Code, 1971, andJor ORS To wit, yowl�q�, <br />(Description of the violation.) <br />and shall remain in effect until <br />This restriction of use is effective beginning on ikuh*—, <br />If you eater in or use any City of Eugene park, open space or facitity 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 - 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 Rorer vela, Blvd., Eugene, Cl <br />97402, <br />The Division Director shall schedule a ti a.nd place for the informal hearing to be conducted, which shall be not more than <br />72 hours ( exclusive 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 />This Notice of Exclusion was delivered to the person named at the top of this Notice at the date and tirne shown above by: <br />(Signatu.;� fice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />� n <br />Wi aturc of per. oil 'b ing issued the n tic el <br />White Copy: Pub is Woiks Gmen Copy: File Yellow Copy: Report Copy Pink Copy: Rc6pivyll G Copw 0— fficer A ppeal nofice Rev, 04103 <br />