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ok <br />notified that you are prohibited from (check box)- <br />X <br />The basis for this Notice of Restriction of Use is that on �/ -- / <br />" Zq you violated Section Lolj(lq) the Park <br />and Open Space Rules, and/or Section o th FUgen e Code, 1971, arid/or OR.S . To wit, you: <br />VJC <br />This restriction of use is effective beginning on 1 /94 11CA —, and shall remain in effect until <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 charge(] 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 toy contest this Notice. A request ror an <br />i n formal hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />with in 48 hours (exclusive of weekends) of receipt o r this N otice at the following address: 1820 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) ofreceipt ofthe request lor 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 of Exclusion was delivered to the person named at the top of this Notice at the 7te and time shown above by: <br />(Signature ofpci-son issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />(Signature of person being issued the notice) - <br />%Vlu c Copy, Public Works Green Copy: File Yellow Copy: Reporl Copy Pink Copy; Rc6pi Gold Copy; OFficer Appeal notice Rev- 04!03 <br />Name: Last <br />First Middle <br />DOB: <br />R ace :Sex <br />-) <br />Rcs. Address: <br />City <br />Start <br />yip <br />R phone <br />Work Phone: <br />ok <br />notified that you are prohibited from (check box)- <br />X <br />The basis for this Notice of Restriction of Use is that on �/ -- / <br />" Zq you violated Section Lolj(lq) the Park <br />and Open Space Rules, and/or Section o th FUgen e Code, 1971, arid/or OR.S . To wit, you: <br />VJC <br />This restriction of use is effective beginning on 1 /94 11CA —, and shall remain in effect until <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 charge(] 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 toy contest this Notice. A request ror an <br />i n formal hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />with in 48 hours (exclusive of weekends) of receipt o r this N otice at the following address: 1820 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) ofreceipt ofthe request lor 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 of Exclusion was delivered to the person named at the top of this Notice at the 7te and time shown above by: <br />(Signature ofpci-son issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />(Signature of person being issued the notice) - <br />%Vlu c Copy, Public Works Green Copy: File Yellow Copy: Reporl Copy Pink Copy; Rc6pi Gold Copy; OFficer Appeal notice Rev- 04!03 <br />