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DATE: <br />LOCATION (PARK/OPEN SPACE): <br />s�s( 5Uo tiA � <br />V( Entering in or using all City of Eugene parks, open spaces or facilities. <br />1 The basis for this Notice of Restriction of Use is that on you violated Section It L 1 of the Park <br />and Open Space Rules, andlor Section of the Eugene Code, 1 971, and/or ORS To wit, you:- <br />(Description of the violation.) <br />NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />TIME: r> <br />N <br />'this restriction of use is effective beginning on and shall remain in effect until <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 />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 of weekends) of receipt of the request for hearing. At the inficirmal 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 inay 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 />6 <br />------------------------- --�s — <br />- - - - -- -- <br />(Signature of person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />N I <br />a N <br />First Middle <br />DOB <br />" V- <br />Race"Ne <br />F:&n A)P�T4JO-A <br />I - <br />IQ <br />Res elllsl: <br />City <br />State <br />Zip <br />Res. Phone: <br />Work Phonei <br />tk' ty <br />V( Entering in or using all City of Eugene parks, open spaces or facilities. <br />1 The basis for this Notice of Restriction of Use is that on you violated Section It L 1 of the Park <br />and Open Space Rules, andlor Section of the Eugene Code, 1 971, and/or ORS To wit, you:- <br />(Description of the violation.) <br />NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />TIME: r> <br />N <br />'this restriction of use is effective beginning on and shall remain in effect until <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 />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 of weekends) of receipt of the request for hearing. At the inficirmal 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 inay 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 />6 <br />------------------------- --�s — <br />- - - - -- -- <br />(Signature of person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />