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NOTICE OF RESTRICTION OF USE <br />DATE: -M/n// <br />TIME: <br />CASE. #. A/- <br />LOCATION (PARK/OPEN SPACE):-4��J�� 6 OLU b, -2�— <br />F Entering in or using all City of Eugene parks, open spaces or facilifie�. <br />0 <br />The basis for this Notice of Restriction of Use is that on 6' $1arIA11-.11111, you violated Section j of the Park <br />and Open Space Rules, and/or Section 4 iq 0 of the Eugene Code, 1971, and/or ORS 166,dO-' . To wit, your <br />ea— 6— 144 <br />Pursuant to Park and Open Space Rule R-1.074 you Eire entitled to an informal hearing to contest this Notice. A request foran <br />informal hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Director <br />within 48 hours (exclusive ol'weekends) of receipt ol'this Notice 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) 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 infonnal hearing. <br />This Notice shall remain in elTvct pending any requested hearing. <br />(Signature of person 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 />White Copy: III 44 orks Grecn Copy: File Yel I ow Copy Report Copy Pink Copy: Rcuipicnn Oold Copy: Offictr Appeal no6ce Rev, 04103 <br />Naine: 1-ast Fin't Middle <br />DOB: <br />Race,/S'c <br />r4k- A CL <br />XS <br />Res. Address: City <br />State <br />Zip <br />Res. Phonc� <br />Work Phone: <br />e-o <br />9 <br />F Entering in or using all City of Eugene parks, open spaces or facilifie�. <br />0 <br />The basis for this Notice of Restriction of Use is that on 6' $1arIA11-.11111, you violated Section j of the Park <br />and Open Space Rules, and/or Section 4 iq 0 of the Eugene Code, 1971, and/or ORS 166,dO-' . To wit, your <br />ea— 6— 144 <br />Pursuant to Park and Open Space Rule R-1.074 you Eire entitled to an informal hearing to contest this Notice. A request foran <br />informal hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Director <br />within 48 hours (exclusive ol'weekends) of receipt ol'this Notice 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) 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 infonnal hearing. <br />This Notice shall remain in elTvct pending any requested hearing. <br />(Signature of person 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 />White Copy: III 44 orks Grecn Copy: File Yel I ow Copy Report Copy Pink Copy: Rcuipicnn Oold Copy: Offictr Appeal no6ce Rev, 04103 <br />