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NOTICE OF RESTRICTION OF USE N os'�5 <br />and Notice of Right to Appeal <br />DATE: <br />TIME I � <br />3 <br />CASE #: <br />LOCAT ION (PARK/OPEN SPACE): k'nT <br />fwl( <br />1111 sl 11 l�1 11 11 11 gli!J1 ulligpill !1? 1 <br />Entering in or using all City of Eugene parks, open spaces or facilities, <br />A <br />The basis for this Notice of Restriction of Use is that on jlj-�&� , you violated Section " 2Q1, of the Park <br />and Open Space Rules, and/or Section - of the Eugene Code, 197 1, and/or OR _Ws 1 To wit, you._ <br />nc - 7 At - :S 7 JC ' 0 1\ fl, It <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 />cu Lo an III If ruarmy contesa ans i ang 101 a] I <br />informal hearing rnWt be made in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />within 4 9 hours (exclusive of weekends) of receipt of 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 info gal 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 an those presenting testimony, from the info al 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 time shown above by: <br />(Signature of person issuing/delivering notice) <br />1 hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />0 1!5 <br />White CopyL Public Workw Greets Copy. File <br />(Signature of person being iSSUed the notice) <br />11�4� <br />Yellow Copy: Report Copy= pink C upy: R ocs pient Goa d Copy: Officer Appeal noact <br />Name: Last — first Middle <br />D013: <br />Race/sex. <br />tv)r C v M ---------- <br />Res. Addre.ss City <br />I <br />State <br />1-- <br />Res. Phone: <br />Work Phone. <br />-(- <br />= <l ...... . .......... . <br />- <br />i <br />1111 sl 11 l�1 11 11 11 gli!J1 ulligpill !1? 1 <br />Entering in or using all City of Eugene parks, open spaces or facilities, <br />A <br />The basis for this Notice of Restriction of Use is that on jlj-�&� , you violated Section " 2Q1, of the Park <br />and Open Space Rules, and/or Section - of the Eugene Code, 197 1, and/or OR _Ws 1 To wit, you._ <br />nc - 7 At - :S 7 JC ' 0 1\ fl, It <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 />cu Lo an III If ruarmy contesa ans i ang 101 a] I <br />informal hearing rnWt be made in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />within 4 9 hours (exclusive of weekends) of receipt of 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 info gal 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 an those presenting testimony, from the info al 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 time shown above by: <br />(Signature of person issuing/delivering notice) <br />1 hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />0 1!5 <br />White CopyL Public Workw Greets Copy. File <br />(Signature of person being iSSUed the notice) <br />11�4� <br />Yellow Copy: Report Copy= pink C upy: R ocs pient Goa d Copy: Officer Appeal noact <br />