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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 />
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