T i 7 L�o <br />m: gillStrarrN - - - - airK aMll Upeil NPHM <br />I — n W02 -3), you NrFfleli <br />notified that you are prohibited from (check box). <br />X Entering in or using all City of Eugene parks, open spaces or facilities. <br />M <br />The basis for this Notice of Restriction of Use is that on you violated Section of the Park <br />and Open Space Rules, 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 2E , and shall remain in effect until —1� ,� ,— <br />If you enter in or use any City o Eugene park, open space or facility during the effective period of this N otice, 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 InMst be made in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />within 4S hours (excl us] ve of weekends) o freceipt of this N once at the fo address: 1820 Roosevelt, Bl vd., E ugene, 0 R <br />97402. <br />72 hours (exclusive of weekends) of receipt of the request For hearing. At the informal hearing the Dividon Director will on <br />consider testimony from you, City personnel involved in the incident, that resulted in this Notice, and other witnesses to t <br />incident. The Division DiTector may exclude anyone, other than you and those presenting testimony, from the infortrial heaTin <br />This Notice shall remain in effect pending any requested hearing. <br />ol'Orson i,msuing/dclivering notice} <br />I hereby acknowledge receipt of the above Notice on the date and tHric indicated above. <br />t <br />(`iiI c person ing issued the notice) <br />Whae Copy; Public Works Green Copy Fi1c, Y Co py • Rcpoft Copy Pin C� ipy ; Rucipi ent Gold Copy: Officer Appeal notice Rev OV03 <br />Nanie: Last Fir4t Pm id(l1c <br />D( il <br />Race/Sex: <br />2P, <br />Re. Address CitV <br />State <br />Zip <br />Re P 1h, c c: <br />Work Phon <br />C) <br />T i 7 L�o <br />m: gillStrarrN - - - - airK aMll Upeil NPHM <br />I — n W02 -3), you NrFfleli <br />notified that you are prohibited from (check box). <br />X Entering in or using all City of Eugene parks, open spaces or facilities. <br />M <br />The basis for this Notice of Restriction of Use is that on you violated Section of the Park <br />and Open Space Rules, 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 2E , and shall remain in effect until —1� ,� ,— <br />If you enter in or use any City o Eugene park, open space or facility during the effective period of this N otice, 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 InMst be made in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />within 4S hours (excl us] ve of weekends) o freceipt of this N once at the fo address: 1820 Roosevelt, Bl vd., E ugene, 0 R <br />97402. <br />72 hours (exclusive of weekends) of receipt of the request For hearing. At the informal hearing the Dividon Director will on <br />consider testimony from you, City personnel involved in the incident, that resulted in this Notice, and other witnesses to t <br />incident. The Division DiTector may exclude anyone, other than you and those presenting testimony, from the infortrial heaTin <br />This Notice shall remain in effect pending any requested hearing. <br />ol'Orson i,msuing/dclivering notice} <br />I hereby acknowledge receipt of the above Notice on the date and tHric indicated above. <br />t <br />(`iiI c person ing issued the notice) <br />Whae Copy; Public Works Green Copy Fi1c, Y Co py • Rcpoft Copy Pin C� ipy ; Rucipi ent Gold Copy: Officer Appeal notice Rev OV03 <br />