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NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />DATE: TIME CASE # <br />LOCATION (PARKJOPEN SPACE) <br />I jjp,���� 111 !111 11 <br />- 01 <br />The basis for this Notice of Restriction of Use is that on you violated Section . —01--oaDf the Park <br />and Open Space Rules, and/or Section of the Eugene Code, 1971, and/or ORS To wit, you:ACJ—CAE <br />IV— I <br />(Description of the violation.) <br />This restriction of use is of beginning on V4LL4--, and shall remain in effect until <br />If you enter in or use any City of Eugene park, open space or facility (luring 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 infrInual 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 ( 66 the Division Director") <br />within 4S, hours (exclusive of weekends) of receipt of this Notice at the following address: 1820 Roosevelt, Blvd., Eugene, Oil <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 (exc I usive o weekends) of receipt of the request for hearing. At the in formal hearing the Division Director wi 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 info al hearing. <br />This Notice shall remain in effect pending any requested hearing. <br />This Notice ol'Exclusion was delivered to the person named at the top of this Notice at the (late �Rd iim t c shown above by: <br />I <br />Ac <br />(Signature of person issuing/de ivering notice <br />I hereby acknowledge receipt of the above Notice on the date and orne indicated above, <br />.... .. - - ------- ---- <br />(Signature of person being issued the notice.) <br />NiVIRtC CUPY, PlAbliC W017k Green Cupy Fite YeMw Copy Report Copy II Cop � kucipicnt Gold Copy: offs el` Appeal notwe Rev, 04 03 <br />°qatne: Last First Middle <br />DOB. <br />Has ei'Sex: <br />C <br />76' u A/ <br />Res. Address: city Statc <br />Zip <br />Res. PhEme: <br />Wor Phone: <br />I jjp,���� 111 !111 11 <br />- 01 <br />The basis for this Notice of Restriction of Use is that on you violated Section . —01--oaDf the Park <br />and Open Space Rules, and/or Section of the Eugene Code, 1971, and/or ORS To wit, you:ACJ—CAE <br />IV— I <br />(Description of the violation.) <br />This restriction of use is of beginning on V4LL4--, and shall remain in effect until <br />If you enter in or use any City of Eugene park, open space or facility (luring 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 infrInual 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 ( 66 the Division Director") <br />within 4S, hours (exclusive of weekends) of receipt of this Notice at the following address: 1820 Roosevelt, Blvd., Eugene, Oil <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 (exc I usive o weekends) of receipt of the request for hearing. At the in formal hearing the Division Director wi 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 info al hearing. <br />This Notice shall remain in effect pending any requested hearing. <br />This Notice ol'Exclusion was delivered to the person named at the top of this Notice at the (late �Rd iim t c shown above by: <br />I <br />Ac <br />(Signature of person issuing/de ivering notice <br />I hereby acknowledge receipt of the above Notice on the date and orne indicated above, <br />.... .. - - ------- ---- <br />(Signature of person being issued the notice.) <br />NiVIRtC CUPY, PlAbliC W017k Green Cupy Fite YeMw Copy Report Copy II Cop � kucipicnt Gold Copy: offs el` Appeal notwe Rev, 04 03 <br />