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NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />DATE: T I M E CASE #. <br />L� <br />lac -- s�v� o <br />LOCATION (PARKJOPEN SPACE) <br />The basis for this Notice of Restriction of Use is that on you violated Section j of the Park <br />and Open Space Rule and/or Section 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 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 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 />within 48 hour-, (exclusive (if weekeril o , cei t of this Notice at the follow address-1 920 Roowwelt Blvd- Ell tene, 0 <br />97402. <br />The Division Director shall schedule a time 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 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 re nested 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 />M6 <br />(Signature of person issuing/dellivering 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 Ctl Public Works CiTeen copy: Pike Y V I I aw Copy: Rel Copy Vink Col Recipient Gold Copy: Officer Appeal no6ce Rev- 04 03 <br />Name: Last A First Middle <br />DOB- <br />Race/Sex: <br />Res. Address: City <br />361 <br />State <br />7s <br />Res, Phone: <br />Work Phone: <br />The basis for this Notice of Restriction of Use is that on you violated Section j of the Park <br />and Open Space Rule and/or Section 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 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 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 />within 48 hour-, (exclusive (if weekeril o , cei t of this Notice at the follow address-1 920 Roowwelt Blvd- Ell tene, 0 <br />97402. <br />The Division Director shall schedule a time 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 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 re nested 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 />M6 <br />(Signature of person issuing/dellivering 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 Ctl Public Works CiTeen copy: Pike Y V I I aw Copy: Rel Copy Vink Col Recipient Gold Copy: Officer Appeal no6ce Rev- 04 03 <br />