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NOTICE OF RESTRICTION OF USE <br />DATE: <br />and Notice of Right to Appeal <br />TIME: CASF #- <br />LOCATION (PARK /OPEN SPACE) <br />I M10 071 ill�ilillillillillill p11111 11111111 1 1 <br />V Entering in or using all City of Eugene parks, open spaces or facilities. <br />The basis for this Notice of Restriction of Use is that on *4v�­ you violated Section LQ k. 418�1 f t h e Par <br />r k <br />and Open Space Mules, and/or Section _q , 4 0 of the Eugene Code, 1971, and/or ORS I I I IIIII-111-1-- 1—� To wit, you._ <br />(Description of the violation.) <br />This restriction of use is effective beginning on 0 and shall remain in effect until 04 <br />A 4 . <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- 1.07=1 you are entitled to kin 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 ofthis Notice at the following addr ss: 1 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 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 head rig <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 />n-k- <br />(Signature of person issuing"'defivering notice) <br />I hereby acknowledge receipt o the above Notice on the date and tint indicated above. <br />(Signature of person being issued the notice) <br />White Copv! public Works Green Ccpy. File Yellow Capy� Report Copy Pink Copy: Recipient G old Copy: Of fi cer A plocal rimice Rev- 04.'03 <br />First Middle <br />l)oo- <br />Res. Address City <br />St to <br />Gitr <br />Res, Phonc <br />(irk Phone: <br />G I r- ' r <br />I M10 071 ill�ilillillillillill p11111 11111111 1 1 <br />V Entering in or using all City of Eugene parks, open spaces or facilities. <br />The basis for this Notice of Restriction of Use is that on *4v�­ you violated Section LQ k. 418�1 f t h e Par <br />r k <br />and Open Space Mules, and/or Section _q , 4 0 of the Eugene Code, 1971, and/or ORS I I I IIIII-111-1-- 1—� To wit, you._ <br />(Description of the violation.) <br />This restriction of use is effective beginning on 0 and shall remain in effect until 04 <br />A 4 . <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- 1.07=1 you are entitled to kin 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 ofthis Notice at the following addr ss: 1 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 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 head rig <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 />n-k- <br />(Signature of person issuing"'defivering notice) <br />I hereby acknowledge receipt o the above Notice on the date and tint indicated above. <br />(Signature of person being issued the notice) <br />White Copv! public Works Green Ccpy. File Yellow Capy� Report Copy Pink Copy: Recipient G old Copy: Of fi cer A plocal rimice Rev- 04.'03 <br />