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11
<br />11111 11 1111111 � 1 1 ! 1,, 111 llj�l 11 1111 1!11111111 1 1 1 11111111111 1!� 1111111111
<br />Entering in or using all CAty of Eugene parks, open spaces or facilities.
<br />M
<br />The basis for this Notice of Restriction of Use is that on kI - , you violated Section LQV of the Park
<br />and Open Space Rules, and/or Section — of the Eugene Code, 1971, and/or ORS --. To wit, you:
<br />(Description of the violation.)
<br />T his restriction of use is effective beginning on and shall remain in effect until 01
<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. Arequest for an
<br />informal hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Director")
<br />within 49 hours (exclusive ol'wcckends of receipt of this Notice at the following addres%: 1820 Roosevelt, Blvd., Eugene, OR
<br />97402.
<br />72 nours (exclusive ol weeKcnas) 51 receipt 01 Me 1VqUC5L 1U1 HVMHlg 1AA UX HiMlllldl UMAIIIIS Ulk: UIVINI
<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 infomial 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 dais Notice at the date and time shown above by:
<br />sig C of person issuing/delivering notice)
<br />I hereby acknowledge receipt of the above Notice on the date and time indicated above.
<br />(Signature of person being issued the notice)
<br />Whau Copy: Public Works Grecn co[rj: vice Yellow cop., rk,p,,, Copy Pink Copy: Redpiont Gold Copy: Offwer Appca9 notiec Rev. 04,'03
<br />Name: Last First Mi dle
<br />DM
<br />Rac e,
<br />N�:
<br />E
<br />-uz - h
<br />Re d(Iress: City State
<br />Zip
<br />Res. Phone:
<br />Work Phone:
<br />11
<br />11111 11 1111111 � 1 1 ! 1,, 111 llj�l 11 1111 1!11111111 1 1 1 11111111111 1!� 1111111111
<br />Entering in or using all CAty of Eugene parks, open spaces or facilities.
<br />M
<br />The basis for this Notice of Restriction of Use is that on kI - , you violated Section LQV of the Park
<br />and Open Space Rules, and/or Section — of the Eugene Code, 1971, and/or ORS --. To wit, you:
<br />(Description of the violation.)
<br />T his restriction of use is effective beginning on and shall remain in effect until 01
<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. Arequest for an
<br />informal hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Director")
<br />within 49 hours (exclusive ol'wcckends of receipt of this Notice at the following addres%: 1820 Roosevelt, Blvd., Eugene, OR
<br />97402.
<br />72 nours (exclusive ol weeKcnas) 51 receipt 01 Me 1VqUC5L 1U1 HVMHlg 1AA UX HiMlllldl UMAIIIIS Ulk: UIVINI
<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 infomial 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 dais Notice at the date and time shown above by:
<br />sig C of person issuing/delivering notice)
<br />I hereby acknowledge receipt of the above Notice on the date and time indicated above.
<br />(Signature of person being issued the notice)
<br />Whau Copy: Public Works Grecn co[rj: vice Yellow cop., rk,p,,, Copy Pink Copy: Redpiont Gold Copy: Offwer Appca9 notiec Rev. 04,'03
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