I I � I 1 1111 111 , 11111 111111 "1 111 rj� !III MIMI ig 111 11111 <br />The basis for this Notice of Restriction of Use is that on you violated Section —0 of the Park <br />and Open Space Rules, and/or Section _ of the Eugene Code, 1971, and/or ORS To wit, you <br />H4N A C�- A LA F-P--C- <br />(Pescription of the violation.) 1 13 V11j <br />This restriction of use is effective beginning on and shall remain in effect until QW0 2- <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. Arequestforan <br />informat hearing must be made in writing and filed with the Parks & Open Space Division Director ("the, Division Director") <br />weekends) �MA Vonsevelt. Blvd.. EuI OR <br />The Division Director shall schedule a time and place for the informal hearing to be conducted, which shall be not niore than <br />72 hours (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. ne Division Director may exclude anyone, other than you and 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 date and time shown ahove by <br />.......... <br />(Si attire of person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />01\j V i <br />( Signature o F person being issued the notice) <br />White Copy: Public Works Greco Copy. File Yellow Copy: Report Copy Pink Copy: Recipient Gold Copy: Officur Appeal notice Kc%� t4'03 <br />Name: Last First Middle <br />DOB: <br />Race. <br />R A;d d r c s s: city <br />State <br />Zip <br />Res. Phone: <br />Work Phone: <br />C I\" I IQ I <br />I I � I 1 1111 111 , 11111 111111 "1 111 rj� !III MIMI ig 111 11111 <br />The basis for this Notice of Restriction of Use is that on you violated Section —0 of the Park <br />and Open Space Rules, and/or Section _ of the Eugene Code, 1971, and/or ORS To wit, you <br />H4N A C�- A LA F-P--C- <br />(Pescription of the violation.) 1 13 V11j <br />This restriction of use is effective beginning on and shall remain in effect until QW0 2- <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. Arequestforan <br />informat hearing must be made in writing and filed with the Parks & Open Space Division Director ("the, Division Director") <br />weekends) �MA Vonsevelt. Blvd.. EuI OR <br />The Division Director shall schedule a time and place for the informal hearing to be conducted, which shall be not niore than <br />72 hours (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. ne Division Director may exclude anyone, other than you and 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 date and time shown ahove by <br />.......... <br />(Si attire of person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />01\j V i <br />( Signature o F person being issued the notice) <br />White Copy: Public Works Greco Copy. File Yellow Copy: Report Copy Pink Copy: Recipient Gold Copy: Officur Appeal notice Kc%� t4'03 <br />