NOTICE OF RES"MICTION OF USE L 4 - d - C D C) <br />and Notice of Right to Appeal <br />I DATE: I IME: CASE #: <br />LOCATION (PARKjOPEN SPACQ IARt R, <br />'E7 <br />i 11 F111111 11 11 rr 1!1111111111111 11111111111111 <br />Entering in or using all City of Eugene parks, open spaces or facilities° <br />ne basis for this N otice of Restriction o Use is that on you violated Scetionj-0100� <br />Dof the Park <br />and Open Space Rules, and/or Section <br />A- � the E ugene Code, 197 1 andJor ORS To wit, yo u.--V-L'Q <br />of- kt,) Ofeti X4,0 ry)ggy ac,6R <br />(Description of the violation.) <br />This restriction of use is effective beginning on VWM—1 and shall remain in effect until 4Qk/ <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 8-1.074 you are entitled to an informal 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 ("!he Division Director") <br />within 48 hours (exclusive of weekend%) of receipt of this Notice at the following address.- 18241 Roosevelt, Blvd., Eugene, OR <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 (exclusive of weekends,'� ofreceiLn of the rekalest for hearin At the informal hearino the Division Director will oulp <br />consider testimony firoin you, City personnel involved in the incident that resulted in this Notice, and other witnesses to the <br />inciden L The Division Director may exclude anyone, other than you and those presenting testimony, from the informal hearing. <br />This Notice shall remain in effect pending any requested hearing. <br />This Notice of Fxclusion was delivered to the person named at the top of this Notice at the d c and time shown above by. <br />(Signature of person issuing/delivering notice) <br />1 hereby acknowledge receipt of the above Notice on the date and time indicated above, <br />ApCb -­ <br />- <br />, , - - - ------- -- -- <br />(Signature ofperson being issued the notice) <br />While Copy! Public Works Circen Copy, He V e [tow C opC Report Copy Pink Copy; Recipient (jold Copy: Officer Appeal nnAice Rev, 04103 <br />Name: LaA First Middle <br />D013: <br />jzace/sex: <br />o af .. ... . ........... <br />Res. Address. City <br />State <br />Zip <br />Res. Phone: <br />Work Phone: <br />6 —PZ <br />I <br />- <br />- <br />i 11 F111111 11 11 rr 1!1111111111111 11111111111111 <br />Entering in or using all City of Eugene parks, open spaces or facilities° <br />ne basis for this N otice of Restriction o Use is that on you violated Scetionj-0100� <br />Dof the Park <br />and Open Space Rules, and/or Section <br />A- � the E ugene Code, 197 1 andJor ORS To wit, yo u.--V-L'Q <br />of- kt,) Ofeti X4,0 ry)ggy ac,6R <br />(Description of the violation.) <br />This restriction of use is effective beginning on VWM—1 and shall remain in effect until 4Qk/ <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 8-1.074 you are entitled to an informal 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 ("!he Division Director") <br />within 48 hours (exclusive of weekend%) of receipt of this Notice at the following address.- 18241 Roosevelt, Blvd., Eugene, OR <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 (exclusive of weekends,'� ofreceiLn of the rekalest for hearin At the informal hearino the Division Director will oulp <br />consider testimony firoin you, City personnel involved in the incident that resulted in this Notice, and other witnesses to the <br />inciden L The Division Director may exclude anyone, other than you and those presenting testimony, from the informal hearing. <br />This Notice shall remain in effect pending any requested hearing. <br />This Notice of Fxclusion was delivered to the person named at the top of this Notice at the d c and time shown above by. <br />(Signature of person issuing/delivering notice) <br />1 hereby acknowledge receipt of the above Notice on the date and time indicated above, <br />ApCb -­ <br />- <br />, , - - - ------- -- -- <br />(Signature ofperson being issued the notice) <br />While Copy! Public Works Circen Copy, He V e [tow C opC Report Copy Pink Copy; Recipient (jold Copy: Officer Appeal nnAice Rev, 04103 <br />