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and Notice of Right to Appeal <br />DATE: TIME: CASE #: <br />LOCATION (PARKYOPEN SPACE), <br />j <br />Entering in or using all City of Eugene parks, open spaces or facilities. <br />7 01 <br />The basis for this Notice of Restriction of Use is that on you violated Section I i j of the Park <br />and Open Space Rules, and/or Section of the Eugene Code, 1971, and/or ORS To wit, you:_ <br />_F P <br />�- �O � <br />(Description of the violation.) <br />"I'his restriction of use is effective beginning on-�!�2- �-O, and shall remain in effect until 0 5 <br />If you enter in or use any City of Eugene park, open space or facility during the efTective 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 infornial hearing to contest this Notice, Arequestforan <br />informal hearing niust be, rnade in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />nftliq Nnllirr- at t�le followina address: ll <br />- III Is I <br />"I "1 11 11 1 11 11 1 i I I I I j, I I IV <br />Tiours (excilusive or weeKenus) oT receipt ol Me requM jor it - 111ill Heal[ Ing ule LjlvtIml uIlluumn wm FARAY <br />caring c 111101 <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 />(Signature ol'person issuing delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above, <br />(Signature of person being issued the notice) <br />Whille C'opvl Public Works Green Copy File Yel low Copy Repots C opy Pink Copy: Recipient Gold Copy Offiecr Appeal notice kev. VW03 <br />Natiic: Last First Mi die <br />I)OB: <br />Race/5 <br />ti <br />C�A <br />- �1� <br />Res. Address: city <br />mat <br />State <br />Zip <br />-91j-1 <br />Res, Phone: <br />Work Phone: <br />rll <br />j <br />Entering in or using all City of Eugene parks, open spaces or facilities. <br />7 01 <br />The basis for this Notice of Restriction of Use is that on you violated Section I i j of the Park <br />and Open Space Rules, and/or Section of the Eugene Code, 1971, and/or ORS To wit, you:_ <br />_F P <br />�- �O � <br />(Description of the violation.) <br />"I'his restriction of use is effective beginning on-�!�2- �-O, and shall remain in effect until 0 5 <br />If you enter in or use any City of Eugene park, open space or facility during the efTective 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 infornial hearing to contest this Notice, Arequestforan <br />informal hearing niust be, rnade in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />nftliq Nnllirr- at t�le followina address: ll <br />- III Is I <br />"I "1 11 11 1 11 11 1 i I I I I j, I I IV <br />Tiours (excilusive or weeKenus) oT receipt ol Me requM jor it - 111ill Heal[ Ing ule LjlvtIml uIlluumn wm FARAY <br />caring c 111101 <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 />(Signature ol'person issuing delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above, <br />(Signature of person being issued the notice) <br />Whille C'opvl Public Works Green Copy File Yel low Copy Repots C opy Pink Copy: Recipient Gold Copy Offiecr Appeal notice kev. VW03 <br />