NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />DATE: c)[OS <br />TIME: 07 C <br />CASE #. <br />a ll 1 <br />R ce"Se <br />LOCATION (PARK/OPEN SPACE): <br />t <br />I <br />If <br />q 111! 1!11 111 1 1 11111111111 111111 111!11!111 11 11111111111 11!11! 11 11 <br />'$— Entering in or using all City of Eugene parks, open spaces or facilitil <br />■ <br />The basis for this Notice of Restriction of Use is that on , you violated Section —ID(D 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 />This restriction of use is effective beginning on (3 10 S I !� and shall remain in effect until <br />0 pts m <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 Direfor") <br />within 48 hours �exclusive of weekerlds), of ix),t cif thk Nntive at, the follow address� 1820 Ro s IVA'Ewne, 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 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. 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 Noti <br />t the date and time shown above by: <br />7 44 3 b <br />(Signo�te of person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above, <br />c <br />(gignature of person beinjissued the notice) <br />White Copy! Public Works Green Copy: File Yellow Copy: Report Copy Pink Copy: Rccipiurn Gold Copy: Officvv Appeal noticc kcv- (W03 <br />Narae: Last H t Middle <br />DO& <br />a ll 1 <br />R ce"Se <br />an <br />L jvS - r <br />Res. Address: city <br />State Zip <br />1 <br />Res. Phane� <br />Work Phow: <br />T W 57 AF-rl -1 <br />q 111! 1!11 111 1 1 11111111111 111111 111!11!111 11 11111111111 11!11! 11 11 <br />'$— Entering in or using all City of Eugene parks, open spaces or facilitil <br />■ <br />The basis for this Notice of Restriction of Use is that on , you violated Section —ID(D 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 />This restriction of use is effective beginning on (3 10 S I !� and shall remain in effect until <br />0 pts m <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 Direfor") <br />within 48 hours �exclusive of weekerlds), of ix),t cif thk Nntive at, the follow address� 1820 Ro s IVA'Ewne, 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 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. 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 Noti <br />t the date and time shown above by: <br />7 44 3 b <br />(Signo�te of person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above, <br />c <br />(gignature of person beinjissued the notice) <br />White Copy! Public Works Green Copy: File Yellow Copy: Report Copy Pink Copy: Rccipiurn Gold Copy: Officvv Appeal noticc kcv- (W03 <br />