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NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />DATE: 10 S TIME: CASE # <br />C / S <br />sl <br />ts <br />LOCATION (PARK/OPEN SPACE): [A)e P Ag—k-- 6 t- <br />Entering in or using all City of Eugene parks, open spaces or facilities. <br />1* <br />The basis for this Notice of Restriction of Use is that on — 6 you violated Section f the Park <br />4 — 4 5 — n <br />and Open Space Rules, and/or Section of the Eugene Code, 1971, and/or OR --1 To wit, you: <br />This restriction or use is effective beginning on 0 116 q and shall remain in effect niI 2-10 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 />W I II 19 to 111JUIN I UNIL IV C ki I WCcKVj1Us) m I CCU 1ptol tj I lz� 1 at tile 10--- --- S� i*.U`US4:Ve1IL, *IV X., <br />97402. <br />The Division Director shall schedule a time and place for the inforinat hearing to be conducted, which shall be not more than <br />72 hours �exclusiye of weekends) of recei ii At thk iiiformnI ht-2rinay thp DiviKinn Director Wj I I cnj <br />_tt of the reXpest for hearin - <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 informal 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 above by: <br />(Sign re of person issuing/delivering notice) <br />Name: Last First Middle <br />DOB <br />lace Sex; <br />T Jo 'I -A <br />Ras. ddress City <br />State <br />Zip <br />Res, Phone: <br />Work Phone: <br />Entering in or using all City of Eugene parks, open spaces or facilities. <br />1* <br />The basis for this Notice of Restriction of Use is that on — 6 you violated Section f the Park <br />4 — 4 5 — n <br />and Open Space Rules, and/or Section of the Eugene Code, 1971, and/or OR --1 To wit, you: <br />This restriction or use is effective beginning on 0 116 q and shall remain in effect niI 2-10 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 />W I II 19 to 111JUIN I UNIL IV C ki I WCcKVj1Us) m I CCU 1ptol tj I lz� 1 at tile 10--- --- S� i*.U`US4:Ve1IL, *IV X., <br />97402. <br />The Division Director shall schedule a time and place for the inforinat hearing to be conducted, which shall be not more than <br />72 hours �exclusiye of weekends) of recei ii At thk iiiformnI ht-2rinay thp DiviKinn Director Wj I I cnj <br />_tt of the reXpest for hearin - <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 informal 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 above by: <br />(Sign re of person issuing/delivering notice) <br />