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NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />c1`6 <br />DATE � — 0 TIME: CASE #: <br />LOCATION (PARK/OPEN SPACE):_,_ <br />I III it Ill !III 111�111111 11111 Il I lil 111111 111111 1111 111111 1' <br />F fli— Entering in or using all City of Eugene parlts, open spaces or facilities. <br />W <br />The basis lor this Notice of Restriction of is that can --6-K --, you violated Section of the Park <br />Opep S pace Rules, and/or Section , of the E Ligene Code, 1971 . andJor ORS To wit, you: <br />(Descfiption of the violation.) <br />This restriction of use is effective beginning on Luzq-, and shall real in effect until - 20� <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 />info al hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />within 48 hours (exclusive of weekend%) of receipt of this Notice at the following address: 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />3n <br />Signat rc of person isistung/dufivcring notice, <br />11 Y <br />I hereby acknowledge receipt oCthc above Notice on the datc and time indicated above. <br />(Signature of person being issued the notice) <br />While Copy: Public Works Grecn cupy� File Yellow Cop Report Copy Pink Copy, Recipient G ol d Copy i 0 fficer Appea not ice Rev- WiM <br />Nair LISt Fi rist Middle <br />D013• <br />Ra(:C X: <br />11 li!C;1 <br />R es, Pkddress� (ay <br />State <br />Zip <br />Res. Phmie <br />Wt Phone: <br />I III it Ill !III 111�111111 11111 Il I lil 111111 111111 1111 111111 1' <br />F fli— Entering in or using all City of Eugene parlts, open spaces or facilities. <br />W <br />The basis lor this Notice of Restriction of is that can --6-K --, you violated Section of the Park <br />Opep S pace Rules, and/or Section , of the E Ligene Code, 1971 . andJor ORS To wit, you: <br />(Descfiption of the violation.) <br />This restriction of use is effective beginning on Luzq-, and shall real in effect until - 20� <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 />info al hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />within 48 hours (exclusive of weekend%) of receipt of this Notice at the following address: 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />3n <br />Signat rc of person isistung/dufivcring notice, <br />11 Y <br />I hereby acknowledge receipt oCthc above Notice on the datc and time indicated above. <br />(Signature of person being issued the notice) <br />While Copy: Public Works Grecn cupy� File Yellow Cop Report Copy Pink Copy, Recipient G ol d Copy i 0 fficer Appea not ice Rev- WiM <br />