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NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />T L — ( I <br />DATE: L LA TIME: I CASE #' <br />�� `t � <br />LOCATION (PARK/OPEN SPACE): <br />Entering in or using all City of Eugene parks, open spaces or facilities. <br />0 <br />The basis for this Notice of Restriction of'Use is that on4 141 t -4") ll /I DA) 4 the Park <br />. you violated Se <br />and Open Space Rules, arl Section , -Z P- of the Eugene Code, 1 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 infer a 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 ol'weekends) of receipt of this Notice at the following address: 1820 Roosevelt, Blvd, Eugene, OR <br />97402. <br />consider testimony from you, City personnel involved in the incident that resulted in this Notice, and o�ther witnesses to t <br />incident. The D ivi qion Director may exclude anyone, other than you and those presenting testimony, from the infortrial 1hearin <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 of person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above, <br />— --------- <br />(Signature of person being issued the notice) <br />White Copy public Works Green Copy; File Yellow Copy: Repon Copy Pink Co pC Recipient G . n I d Copy O fficer A ppeal notice Re%•- 04 M3 <br />Ao 357 W <br />. <br />ast <br />d" ast First <br />DOB: <br />RL , ice.� -ex, <br />z <br />I r15 li <br />7 7 <br />Res� Addrc <br />Se <br />Zip <br />Res, Phone. <br />Work Phone� <br />r . so - r <br />Entering in or using all City of Eugene parks, open spaces or facilities. <br />0 <br />The basis for this Notice of Restriction of'Use is that on4 141 t -4") ll /I DA) 4 the Park <br />. you violated Se <br />and Open Space Rules, arl Section , -Z P- of the Eugene Code, 1 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 infer a 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 ol'weekends) of receipt of this Notice at the following address: 1820 Roosevelt, Blvd, Eugene, OR <br />97402. <br />consider testimony from you, City personnel involved in the incident that resulted in this Notice, and o�ther witnesses to t <br />incident. The D ivi qion Director may exclude anyone, other than you and those presenting testimony, from the infortrial 1hearin <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 of person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above, <br />— --------- <br />(Signature of person being issued the notice) <br />White Copy public Works Green Copy; File Yellow Copy: Repon Copy Pink Co pC Recipient G . n I d Copy O fficer A ppeal notice Re%•- 04 M3 <br />