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NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />DATE: J) TIME *3 CASE 4 <br />LOCATION (PARK/OPEN SPACE). <br />M <br />and Open Space Rules, and/or Section <br />(Description of the violation.) <br />o f the Eugene Code, 197 1, and/or ORS To wit, you:_ <br />0 <br />This restriction of use is effective beginning on 0 31 and shall remain in effect untilA3J1.-,1A—. <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 />Pursuint to Park and Open Space Rule R- L074 you are entitled to an informal hearing to contest this Notice: A request for an <br />informal hearing inust 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., Eugene, OR <br />97402. <br />The Division Director shall schedule a tirric 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 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 time shown above by: <br />(Signature r-erson issuing /delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />(Signature of person being issued the notice) <br />White Copy Public Works G men Copy_ File Y el4 Copy Report Copy Pirik Copy! Recipielit Guld Copy: Officer Appeal nomc� Rev, 04,103 <br />Name� Last <br />First Middle <br />D013. <br />Race., <br />Res. Address: <br />r= <br />City <br />State <br />Zip <br />Res, Phone: <br />Work Phone: <br />a <br />M <br />and Open Space Rules, and/or Section <br />(Description of the violation.) <br />o f the Eugene Code, 197 1, and/or ORS To wit, you:_ <br />0 <br />This restriction of use is effective beginning on 0 31 and shall remain in effect untilA3J1.-,1A—. <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 />Pursuint to Park and Open Space Rule R- L074 you are entitled to an informal hearing to contest this Notice: A request for an <br />informal hearing inust 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., Eugene, OR <br />97402. <br />The Division Director shall schedule a tirric 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 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 time shown above by: <br />(Signature r-erson issuing /delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />(Signature of person being issued the notice) <br />White Copy Public Works G men Copy_ File Y el4 Copy Report Copy Pirik Copy! Recipielit Guld Copy: Officer Appeal nomc� Rev, 04,103 <br />