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NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />DATE: TIME: CASE#: <br />—X - — ---- — - — - — ----------- ------ <br />LOCATION (PARKJOPEN SPACE):--- 9 1 5L <br />(Description of the violation.) <br />I I <br />This restriction of use is effective beginning on 632---)LI !1-1 and shall remain in effect until OV- <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 R ul c ti- 1 .074 you are entitl to an info rnia I hearin tea contest this Notice. A request for an <br />infer Taal hearing must be made in writing and filed with the Parks & Open Space Division Director ( ' "the Division Director") <br />withi n 49 hours (exclusive of week ends) of receipt of this No tice at the fol [owing address: 1820 Roosevelt., Blvd., E u gene, OR <br />97402m <br />The Division Director shall schedule a time and place for the informal hearing to be conducted, which shall be not mote than <br />72 hours (exclusive of weekends) of receipt of the request for hearing. At the informal hearing the Division Director will only <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 effect pending any requested hearing. <br />This Notice ol'Exclusion was delivered to the person named at the top of this Notice at the date and time shown abo by! <br />d e l <br />Aiv <br />(Signature orfppelson issuing/deivering notice) <br />t hereby ackDOWledge receipt of the above Notice on the date and time indicated above. <br />(Signature of person being issued the notice) <br />Wh i le C upy; Pu Work,, Green Copy; File Yellow Copy: Repoti Copy Pink Copy; Recipient G old Copy - 0 fficer a ppea l not ice Rev 04 03 <br />Nal Ce LaSt First Middle <br />1)013: <br />R"- Address: City <br />a <br />--AD--(?, ��-]Tt�tv <br />State <br />Zip <br />I !t <br />Res. Phone: <br />----L- -?LT+ <br />Work Phon <br />(Description of the violation.) <br />I I <br />This restriction of use is effective beginning on 632---)LI !1-1 and shall remain in effect until OV- <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 R ul c ti- 1 .074 you are entitl to an info rnia I hearin tea contest this Notice. A request for an <br />infer Taal hearing must be made in writing and filed with the Parks & Open Space Division Director ( ' "the Division Director") <br />withi n 49 hours (exclusive of week ends) of receipt of this No tice at the fol [owing address: 1820 Roosevelt., Blvd., E u gene, OR <br />97402m <br />The Division Director shall schedule a time and place for the informal hearing to be conducted, which shall be not mote than <br />72 hours (exclusive of weekends) of receipt of the request for hearing. At the informal hearing the Division Director will only <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 effect pending any requested hearing. <br />This Notice ol'Exclusion was delivered to the person named at the top of this Notice at the date and time shown abo by! <br />d e l <br />Aiv <br />(Signature orfppelson issuing/deivering notice) <br />t hereby ackDOWledge receipt of the above Notice on the date and time indicated above. <br />(Signature of person being issued the notice) <br />Wh i le C upy; Pu Work,, Green Copy; File Yellow Copy: Repoti Copy Pink Copy; Recipient G old Copy - 0 fficer a ppea l not ice Rev 04 03 <br />