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NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />DATE: V-1wNt-- TIME: 11119 CASE <br />LOCATION (PARKIOPEN SPACE)._,6;7A� <br />Entering in or using all City of Eugene parks, open spaces or facilities. <br />ICI <br />The basis for this Notice of Restrictiou of Use is that on —VX DOLL—, you violated Section ) 0 - Xii&f the Park <br />and Open Space Rules, and/or Section 1 4 )L 210 - of the Eugene Code, 197 1, and/or ORS —. To wit, you- <br />UL) e-1 <br />(Description of the violation.) <br />This restriction of use is effective beginning on A6 and shall rernain in effect until —VIV—ICL— <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 R- 1,074 you are entitled to an infer al 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 ("the Division Director") <br />within 4 hours (exclusive of weekends) of receipt of this Notice at the fo I ]owing address: 1820 Roosevelt, Blvd, E ugene, 0 R <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 info al 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 info al hearing. <br />This Notice shall remain in effect pending any requested hearing. <br />This Notice of Lxclusion was delivered to the person named at the top of this Notice at the date and time shown above by: <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />01 <br />(Signature of person being issued the notice) <br />White Copv Public Works Green Copy flle Yellow Copy Report Copy Pink Copy: Recipient Gold Copy'. Officer Appeal notice Rcv- (A03 <br />Nance: Last First Middle <br />D013: <br />Race/Sex: <br />�DNRC 0 <br />Res. Address: City <br />State <br />Zip <br />Res. Phone: <br />Work Phone <br />Entering in or using all City of Eugene parks, open spaces or facilities. <br />ICI <br />The basis for this Notice of Restrictiou of Use is that on —VX DOLL—, you violated Section ) 0 - Xii&f the Park <br />and Open Space Rules, and/or Section 1 4 )L 210 - of the Eugene Code, 197 1, and/or ORS —. To wit, you- <br />UL) e-1 <br />(Description of the violation.) <br />This restriction of use is effective beginning on A6 and shall rernain in effect until —VIV—ICL— <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 R- 1,074 you are entitled to an infer al 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 ("the Division Director") <br />within 4 hours (exclusive of weekends) of receipt of this Notice at the fo I ]owing address: 1820 Roosevelt, Blvd, E ugene, 0 R <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 info al 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 info al hearing. <br />This Notice shall remain in effect pending any requested hearing. <br />This Notice of Lxclusion was delivered to the person named at the top of this Notice at the date and time shown above by: <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />01 <br />(Signature of person being issued the notice) <br />White Copv Public Works Green Copy flle Yellow Copy Report Copy Pink Copy: Recipient Gold Copy'. Officer Appeal notice Rcv- (A03 <br />