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NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />LOCATION (PARKJOPEN SPACE): - ------ <br />M It - My <br />notified that you are prohibited from (check box): <br />Entering in or using all City of Eugene parks, open spaces or facilities. <br />0 <br />- 7 - 3( <br />The basis for this Notice of Restriction of Use is that on you violated Section of the Park <br />and Open Space Rules, and lor Section of the Eugene Code, 197 1, and/or ORS To wit, you: <br />/I A A I <br />MM <br />(Description of the violation.) <br />M <br />This restriction of use is effective beginning on and shall remain in effet until 0 <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 - 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 ofweekcnds) 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 inftninai hearing to be conducted, wbich shall be not more than <br />712 hours (exclusive of weekends.) of receipt of the request for hearing. At the info al 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, fTom 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 e dale and time shown above by: <br />a . <br />Notice. I th <br />- 31 <br />---- ------- <br />S L <br />p erson �e of erson issuing/defivering notice) <br />oil <br />(Signa. re of p <br />I hereby acknowledge receipt of the above Notice on the date and thne indicated above. <br />(Signature, of person being issued the notice) <br />WBe Copy: Public Work� G ccn Copy: YAP Yellow Copy� Rcpon Copy Punk Copy R"ipicnt Gold Copy: Ofter Appeal notice Rev- OV03 <br />Name� Last First Middle <br />[)( <br />[far e <br />q,� 3 <br />C <br />Req, Address: C'aty <br />State <br />Zip <br />Res Phone: <br />Work 1 <br />M It - My <br />notified that you are prohibited from (check box): <br />Entering in or using all City of Eugene parks, open spaces or facilities. <br />0 <br />- 7 - 3( <br />The basis for this Notice of Restriction of Use is that on you violated Section of the Park <br />and Open Space Rules, and lor Section of the Eugene Code, 197 1, and/or ORS To wit, you: <br />/I A A I <br />MM <br />(Description of the violation.) <br />M <br />This restriction of use is effective beginning on and shall remain in effet until 0 <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 - 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 ofweekcnds) 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 inftninai hearing to be conducted, wbich shall be not more than <br />712 hours (exclusive of weekends.) of receipt of the request for hearing. At the info al 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, fTom 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 e dale and time shown above by: <br />a . <br />Notice. I th <br />- 31 <br />---- ------- <br />S L <br />p erson �e of erson issuing/defivering notice) <br />oil <br />(Signa. re of p <br />I hereby acknowledge receipt of the above Notice on the date and thne indicated above. <br />(Signature, of person being issued the notice) <br />WBe Copy: Public Work� G ccn Copy: YAP Yellow Copy� Rcpon Copy Punk Copy R"ipicnt Gold Copy: Ofter Appeal notice Rev- OV03 <br />