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NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />DATE: 19 TIME: Ph_ CASE #: <br />`TA titKoh <br />j <br />LOCATION (PARK/0PEN . <br />M , <br />M "M 5VM Se a 0 rM" <br />notirred that you are prohibited from (check box): <br />FIRM <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 or the, Eugene Code, 1971, and/or ORS, T'o wit, you- _V <br />9,7t-- F03SKAMOP—OF <br />(Description of the violation.) <br />This restriction of use is effective beginning on N" - LLI — I and shall remain in effect until 14VL/ff-- <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, Arequestforan <br />informal hearing must be irrade M writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />within 48 hours (exclusive ofweekends) 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 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 effeetpending any requested hearing. <br />(Sig mare - of�pe� <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />(qllgnature of person being issued the notice) <br />White Copy: 1 ublw Wcrk�, Green Copy: Filc Ycl kov Copy: Report Copy Pink Copy, Rc6piQnt Go ld Copy: Officer A ppeal not i cc Rev 0410 <br />Name.: Last First Middle <br />I )� <br />R"Icefsex. <br />j .7—M07Yf <br />%)B <br />Res. Addres city <br />State <br />Work Phonee <br />Tp P W — <br />E �� <br />M , <br />M "M 5VM Se a 0 rM" <br />notirred that you are prohibited from (check box): <br />FIRM <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 or the, Eugene Code, 1971, and/or ORS, T'o wit, you- _V <br />9,7t-- F03SKAMOP—OF <br />(Description of the violation.) <br />This restriction of use is effective beginning on N" - LLI — I and shall remain in effect until 14VL/ff-- <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, Arequestforan <br />informal hearing must be irrade M writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />within 48 hours (exclusive ofweekends) 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 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 effeetpending any requested hearing. <br />(Sig mare - of�pe� <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />(qllgnature of person being issued the notice) <br />White Copy: 1 ublw Wcrk�, Green Copy: Filc Ycl kov Copy: Report Copy Pink Copy, Rc6piQnt Go ld Copy: Officer A ppeal not i cc Rev 0410 <br />