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NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />DATE: TIME 1 0 S/ t CASE # <br />LOCATION (PARK," OPEN SPACE):WA PA-fl-k- <br />,I)m Entering in or using all City of Eugene parks, open spaces or facilities <br />V <br />The basis for this Notice of Restriction of Use is that on you violated Section. Is 1 of the Park <br />and Open Space Rules, and/or Section of the E ugene Code, 1971, and/or ORS . To wit., you: <br />W 6IJ 0 PG�J <br />(Description of the violation,) <br />This restriction of use is effective beginning on 1*24 ' L4 LI ' and shall remain 5 <br />4 <br />in effect until V_ <br />7 — —D <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 />within 48 hours (exclusive of weekends) of receipt of this Notice at the following address- 1820 Roosevelt, Blvd., EugenL, 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 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 infornial 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 abovc by: <br />(Si ature of person issuing./delivering notice <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />%Vh4k� Copy; Nblic Works Green Copy: File Yellow Copy: RcTur( Copy Nnk Copy: Recipient <br />Nanre Last First Middle <br />DOB: <br />LJ <br />Res- Address: City <br />St r t e <br />Zip <br />F <br />Res, Phone: <br />Work Phone: <br />J io <br />) w <br />,I)m Entering in or using all City of Eugene parks, open spaces or facilities <br />V <br />The basis for this Notice of Restriction of Use is that on you violated Section. Is 1 of the Park <br />and Open Space Rules, and/or Section of the E ugene Code, 1971, and/or ORS . To wit., you: <br />W 6IJ 0 PG�J <br />(Description of the violation,) <br />This restriction of use is effective beginning on 1*24 ' L4 LI ' and shall remain 5 <br />4 <br />in effect until V_ <br />7 — —D <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 />within 48 hours (exclusive of weekends) of receipt of this Notice at the following address- 1820 Roosevelt, Blvd., EugenL, 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 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 infornial 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 abovc by: <br />(Si ature of person issuing./delivering notice <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />%Vh4k� Copy; Nblic Works Green Copy: File Yellow Copy: RcTur( Copy Nnk Copy: Recipient <br />