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Mir Me V 7 <br />notified that you are probibitedfroni (check box): <br />Enteringin or using all City of Eugene parks, open spaces or facilitil <br />The basis tsar this Notice of Restriction of Use is that on you violated Section 11—OLX —ILI-)if the Park <br />and Open Space Rules, and/or Section . M_'O of the Eugene Code, 1971, and/or OR To wit, yet; <br />(Description of the violation.) <br />This restriction of use is effective beginning on and shall remain in effect until*24/4t <br />Ifyou enter in or use any City of Eugene park open spacc 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 ,1174 you are entitled to an in.formal hearing to contest this Notice. A request for an <br />inron hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Director <br />within 48 hours (exclusive orweeken&) 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 frorn 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 infonnal hearing. <br />This Notice shall remain in effect pending any requested hearing. <br />Th is N otice of Exclusion was delivered to the person rianied at the top of this Notice at the date and ti rare shown above by! <br />39 <br />(Signature of person issuing/c efivering noticel <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />V2- <br />(Signature of person being issued the notice) <br />Whae Copy! Puhfic Work3 Green Copy. File Yellow Copy: Ruporl Copy Pink Copy� Recipient Gold Copy: Officer Appeal notice Rev- iA I <br />me: Last First Middle <br />DW <br />Racc,`S !x: <br />z <br />7uu a 0 /L/7<YkbI - <br />I Y <br />I <br />ReQ,. Address: City St ate <br />7r <br />Zip <br />Res. Phone: <br />Work Phone: <br />Mir Me V 7 <br />notified that you are probibitedfroni (check box): <br />Enteringin or using all City of Eugene parks, open spaces or facilitil <br />The basis tsar this Notice of Restriction of Use is that on you violated Section 11—OLX —ILI-)if the Park <br />and Open Space Rules, and/or Section . M_'O of the Eugene Code, 1971, and/or OR To wit, yet; <br />(Description of the violation.) <br />This restriction of use is effective beginning on and shall remain in effect until*24/4t <br />Ifyou enter in or use any City of Eugene park open spacc 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 ,1174 you are entitled to an in.formal hearing to contest this Notice. A request for an <br />inron hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Director <br />within 48 hours (exclusive orweeken&) 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 frorn 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 infonnal hearing. <br />This Notice shall remain in effect pending any requested hearing. <br />Th is N otice of Exclusion was delivered to the person rianied at the top of this Notice at the date and ti rare shown above by! <br />39 <br />(Signature of person issuing/c efivering noticel <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />V2- <br />(Signature of person being issued the notice) <br />Whae Copy! Puhfic Work3 Green Copy. File Yellow Copy: Ruporl Copy Pink Copy� Recipient Gold Copy: Officer Appeal notice Rev- iA I <br />