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NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />DATE: TIME: CASE <br />"6 <br />LOCATION (PARK/OPFN SPACE): <br />A!56 1 �A s �U <br />(Description of the violation.) <br />This restriction of use is effective beginning on 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 charged 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 to contest this Notice. A request for an <br />inflormal hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />within 49 hours (exclusive of weekends) of receipt of this Notice at the following address: 1820 Rnos" Blvd., Eugene, OR <br />97402. <br />The Division Director shall schedule a time and place for the inl'ormal 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 infor hearing the Division Director will only <br />consider testimony from you, City personnel involved in the incident that TeSUIted in this Notice, and other witnesses it) 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 date and time shown above by: <br />- - - - -- ----------- <br />(Signature of person iSSUing/dChVeriDg 1106CC) <br />I hereby acknowledge receipt of the above Notice on the date: and time indicated above. <br />(Signature of per son being issued the notice) <br />White Copy- Pubhe Work& Green Copy: File YcHow Copy: Report COPY Pink Copy! Reripwnt Gold Copv: 0 ffi cer Appee notice Rev 04,101 <br />Name: Last First Middle <br />D( 0 <br />K' <br />Res. Address,: city <br />State <br />Zip <br />Res. Phone: <br />Work Phone: <br />----------- <br />A!56 1 �A s �U <br />(Description of the violation.) <br />This restriction of use is effective beginning on 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 charged 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 to contest this Notice. A request for an <br />inflormal hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />within 49 hours (exclusive of weekends) of receipt of this Notice at the following address: 1820 Rnos" Blvd., Eugene, OR <br />97402. <br />The Division Director shall schedule a time and place for the inl'ormal 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 infor hearing the Division Director will only <br />consider testimony from you, City personnel involved in the incident that TeSUIted in this Notice, and other witnesses it) 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 date and time shown above by: <br />- - - - -- ----------- <br />(Signature of person iSSUing/dChVeriDg 1106CC) <br />I hereby acknowledge receipt of the above Notice on the date: and time indicated above. <br />(Signature of per son being issued the notice) <br />White Copy- Pubhe Work& Green Copy: File YcHow Copy: Report COPY Pink Copy! Reripwnt Gold Copv: 0 ffi cer Appee notice Rev 04,101 <br />