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NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />DATE: j2 �7jj TIME: 24 q V CASE #: <br />LOCATION (PARK/OPEN SPACE) <br />k 0 Cjq e v \ / S C- <br />ty5 3 V5 <br />L- <br />c-) eJ P A 1z <br />lorny T, _'-UJ-L4-"HU rHrK M%, Upell'NpaCe rMle kII-Imuz-)(1), V <br />notified that you are prohibited from (check box) <br />Entering in or using all City of Eugene parks, open spaces or facilities. <br />The basis f0T this Notice of Restriction of Use is that on VJ2 4 L you violated Section p 0 /0 of the Park <br />and Open Space Rules, and)or Section 'l, 2- q 0 <br />( bf the Eugene Code, 1971, and/or ORS To wit, you <br />it-3 _k&5 of- f6AARk-lL-L-AKA AtJb Aueo&t_ <br />(Description of the violation.) <br />This restriction of use is effective beginning on I and shall remain in effect until 0 1 L � <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 />informal hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />within 48 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 ol'weekends) of receipt of the request for hearing. At the infornial hearing, the Division Director will only <br />consider testimony fro m you, City personnel involved in the incident that resulted in this Notice, and other witnesses to the <br />incident. The Division Director inay exclude anyone, other than you and those presenting testimony, from the informal hearing. <br />This Notice shall remain in efrect pending any requested hearing. <br />This Notice of Exclusion was delivered to the person named at the top of this No i P at the date d time shown above by: <br />( <br />2- <br />C" <br />Sign re of'person issuing/deliverlig notie <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 />Whitu Copy Public works Green Copy: File Y Copy: Report Copy Pink Copy• Recipient GkAd Copy Officer Appeal notice Rev 04,'03 <br />Name: Last First Middle <br />DO <br />Race/Sex <br />22�r^ <br />Lt_ <br />Res. Address: city <br />State <br />Zip <br />Res. Phmic <br />_LL <br />Work Phone: <br />�T <br />lorny T, _'-UJ-L4-"HU rHrK M%, Upell'NpaCe rMle kII-Imuz-)(1), V <br />notified that you are prohibited from (check box) <br />Entering in or using all City of Eugene parks, open spaces or facilities. <br />The basis f0T this Notice of Restriction of Use is that on VJ2 4 L you violated Section p 0 /0 of the Park <br />and Open Space Rules, and)or Section 'l, 2- q 0 <br />( bf the Eugene Code, 1971, and/or ORS To wit, you <br />it-3 _k&5 of- f6AARk-lL-L-AKA AtJb Aueo&t_ <br />(Description of the violation.) <br />This restriction of use is effective beginning on I and shall remain in effect until 0 1 L � <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 />informal hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />within 48 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 ol'weekends) of receipt of the request for hearing. At the infornial hearing, the Division Director will only <br />consider testimony fro m you, City personnel involved in the incident that resulted in this Notice, and other witnesses to the <br />incident. The Division Director inay exclude anyone, other than you and those presenting testimony, from the informal hearing. <br />This Notice shall remain in efrect pending any requested hearing. <br />This Notice of Exclusion was delivered to the person named at the top of this No i P at the date d time shown above by: <br />( <br />2- <br />C" <br />Sign re of'person issuing/deliverlig notie <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 />Whitu Copy Public works Green Copy: File Y Copy: Report Copy Pink Copy• Recipient GkAd Copy Officer Appeal notice Rev 04,'03 <br />