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NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />DATE I — ,),k (I L A TIME CASE <br />Aa 51 — <br />LOCATION IPA PK/OPFN SPACE)� Lk, % PC k4 <br />5�5 t 5n- <br />6 o <br />� <br />I _ <br />(Description of the violation.) A -J 0 <br />inning on 1 6 1 , and shall remain in, effect until t a) �L I S � <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 />in Formal hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Direclor­1 <br />within 48 hours (exclusive of weekends) of receipt of this Notice at the following address: 1820 Roosevelt, Blvd., Eugene, OR <br />97402, <br />M E ; Res I n U lNunt-C, ullu QU <br />cOnsi er mony Hui Ait Milk VUStUA VV1U <br />incident. The Division Director may exclude anyone, other than you and those presenting testimony, from the informal hearing. <br />This Noticeshall reinain 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 sho above by; <br />z <br />(,Signature. of person is. notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />0 <br />(Signature of person being issued the notice) <br />White C opy: Pub I i k! Works Green Copy: File Yellow Copy: Report Copy Pink Copy: Rucipient Gold Copy! Offico Appeal notice Rev- IWO <br />Name: Last First Middle <br />DOB� <br />Race/Sex: <br />' t <br />ioc <br />E <br />Re& dress: City <br />State <br />Zip <br />Res. Phones <br />Work Phone: <br />(Description of the violation.) A -J 0 <br />inning on 1 6 1 , and shall remain in, effect until t a) �L I S � <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 />in Formal hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Direclor­1 <br />within 48 hours (exclusive of weekends) of receipt of this Notice at the following address: 1820 Roosevelt, Blvd., Eugene, OR <br />97402, <br />M E ; Res I n U lNunt-C, ullu QU <br />cOnsi er mony Hui Ait Milk VUStUA VV1U <br />incident. The Division Director may exclude anyone, other than you and those presenting testimony, from the informal hearing. <br />This Noticeshall reinain 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 sho above by; <br />z <br />(,Signature. of person is. notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />0 <br />(Signature of person being issued the notice) <br />White C opy: Pub I i k! Works Green Copy: File Yellow Copy: Report Copy Pink Copy: Rucipient Gold Copy! Offico Appeal notice Rev- IWO <br />