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NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />TIME: CASE <br />IJN <br />LOCATION (PARK/OPEN SPACE): �Ix 13 lacez'ti <br />U nder the authority of Ad ministrative O rder No. 58-03-24-F and Pa rk and Open Space Rule R- 1 A05(3), You are hereby <br />notified that you are prohibited from (check box)- <br />Entering in or using all City of Eugene park%, open spaces or facilities. <br />4 <br />The basis for this Notice of Restriction of Use is that on you violated Section 0/ -)Vf the Park <br />and Open Space Rules, and/or Section J%-1q-0 of the Eugene Code, 1971, and/or ORS To wit, you:__ <br />(Description of the violation.) <br />This restriction of use is effective beginning on and shall remain in effect ninfil b s)) <br />Ifyou 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 />infra al hearing muqt 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, Eu OR <br />gene, <br />97402. <br />(Signature of'person issuing/delivering notice <br />I hereby acknowledge receipt of the` above Notice on the date and firne indicated above. <br />WIT tj R CA <br />(Signature of person being issued the notice) <br />White Copy: Public Work: (h en Copy! File Yel�ow Copy: kupork C opy Pink Copy; Recipient Ooki Copy Offlicei Appeal nottce pxv, WACO <br />Namc. Last First Middle <br />D013. <br />Rac&,% <br />k <br />........ .. j PIP A� A <br />V <br />Rc, Addreors: Ci1V <br />state <br />zi <br />Res- 1 <br />Vht)ne: <br />32 14 t 4- <br />sl-- BY <br />�to- tl <br />U nder the authority of Ad ministrative O rder No. 58-03-24-F and Pa rk and Open Space Rule R- 1 A05(3), You are hereby <br />notified that you are prohibited from (check box)- <br />Entering in or using all City of Eugene park%, open spaces or facilities. <br />4 <br />The basis for this Notice of Restriction of Use is that on you violated Section 0/ -)Vf the Park <br />and Open Space Rules, and/or Section J%-1q-0 of the Eugene Code, 1971, and/or ORS To wit, you:__ <br />(Description of the violation.) <br />This restriction of use is effective beginning on and shall remain in effect ninfil b s)) <br />Ifyou 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 />infra al hearing muqt 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, Eu OR <br />gene, <br />97402. <br />(Signature of'person issuing/delivering notice <br />I hereby acknowledge receipt of the` above Notice on the date and firne indicated above. <br />WIT tj R CA <br />(Signature of person being issued the notice) <br />White Copy: Public Work: (h en Copy! File Yel�ow Copy: kupork C opy Pink Copy; Recipient Ooki Copy Offlicei Appeal nottce pxv, WACO <br />