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& Entering in or using all City of Eugene parks, open spaces or facilities. <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 />informal hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />weekends) of receint of this Notice. at the fol ???. address: 1820 Roosevelt. Blvd., Eugene. OR <br />The Division Director shall schedule a time and place for the infon hearing to be conducted, which shall be not more than <br />7" hours (exclusive of weekends) of receipt of the request for hearing. At the in l'ormal hearing <br />Z - _, the Division Director Neill 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, 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 narned at the top of this Notice at the date and time shown above by <br />t (o <br />(Signature of person iSSUing/deiivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />(Signature of'person being is. the notice) <br />White Copy: PuMiu Works Green Copy! Filc Yellow Copy: Rwart Copy Pink C V.y! Reopimt Gold Copy: Offic�r AppeaE notice Rm 04sU3 <br />Name: LastT <br />j First h Midtlle <br />DOB <br />c! <br />Race'Sex: <br />23 <br />Res. Addreqs: <br />State <br />Zip <br />Res. Phone: <br />Work Phone: <br />& Entering in or using all City of Eugene parks, open spaces or facilities. <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 />informal hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />weekends) of receint of this Notice. at the fol ???. address: 1820 Roosevelt. Blvd., Eugene. OR <br />The Division Director shall schedule a time and place for the infon hearing to be conducted, which shall be not more than <br />7" hours (exclusive of weekends) of receipt of the request for hearing. At the in l'ormal hearing <br />Z - _, the Division Director Neill 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, 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 narned at the top of this Notice at the date and time shown above by <br />t (o <br />(Signature of person iSSUing/deiivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />(Signature of'person being is. the notice) <br />White Copy: PuMiu Works Green Copy! Filc Yellow Copy: Rwart Copy Pink C V.y! Reopimt Gold Copy: Offic�r AppeaE notice Rm 04sU3 <br />