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NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />DATE: o-1 TIME: CASE # <br />LOCATION (PARK/OPEN SPACE): F, <br />I <br />N / / , r-*,o , <- ,,- as;,k A - q <br />,- <br />Naine Last First Middle <br />DOB: <br />Racc/Sex: <br />z <br />W A- C; r 4 g ot" e- f- <br />C7 RL4�� <br />U <br />09 <br />Res, Address� cily <br />State <br />Zip <br />p <br />lc <br />Pes, Pho. <br />Wc3rk Phone <br />- ti, I III I I III IN 11 Jill 1111 11111 111 1111111 111' 1 Jill 111 VIIIIIIII 1 11 1 1 1 1 <br />,W Entering in or using all City of Eugene parks, open spaces or facilities. <br />X <br />� (W) <br />The n i, basis for this Notice of Restriction of Use is that o you violated Section oic <br />ofthe Park <br />and Open Space Rules, and/or Section of the Eugene Code, 1971, and/or ORS To wit, you: <br />-rrrg 4 'AW�,kz4qrj <br />Jill RC->,rAr-z r- ---T-rc-c <br />(,Description of the violation.) <br />This restriction of use is effective beginning on oq <br />2Y & 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 8- you are entitled to an info rma I hearing to contest thiq Notice Arequest for an <br />informal hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Director') <br />within 4 hours (exclu sive of weekends) of receipt oft i s Notice at the following address: 1820 Roasevel t, B Ilvd., Eugene, 0 R <br />97402. <br />The Division Director %hall schedule a time and place for the informal hearing to be conducted, which �hal I be not more than <br />72 hours (,exclusive of weekends) of recei!2t of the reoue-,t for henring,. At the in formal hearin the [)ivisinn Director wil I oU4 <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, In ilormal 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 />(Signature of person iSSUing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above, <br />&ff ------ - ------ ---------- <br />(Sig of person being issued the notice) <br />Whille cupy Public Works Green copy: File Ye A ow C=opy Report Copp Pink Copv: Recipient Cold Copy off ceir Appeal nollice Rev- (W03 <br />