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NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />b �s i� I k Ili <br />DAM, TIME: t _11 CASE <br />LPLYA_ <br />LOCATION (PAR, /OPEN SPACE):_j C_Aszr�, ,. �t <br />ry- <br />11 Eli 11 11 M11111111 iiffl!piigrIi� M1111 I � III <br />I!P 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 you violated Section 1 of the Park <br />and Open Space Rules, and/or Section o the Eugene Code, 1971 and/or ORS To wit, you: <br />O'he r)f 7,c 1z C' as e <br />(Description of the violation.) <br />This restriction of use b <br />I I ' I , S I and Shall reMill 1 v c u t <br />'LL 4 R ffe t a if _ <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 />JUSIVe 01 WCeK 1.7-91 <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 trom you, City personnel involved in the incident that resulted in this Notice, and other witnesses to the <br />incident. The Division Director maN exclude an%one, other than Xou and those ji s e ( I I , earin 9— <br />LLitntin% testimony, from th inf)m a h <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 a d time shown above by: <br />ti <br />(Signature of person issuing/delivering notice) <br />I hereby acknowledge receipt or the above Notice on the, date and time indicated above. <br />V7 <br />(Signature of person being issued the notice) <br />Whae Copy: Public: 'WorL Green Copy: File Yellow COPY! Repoli Copy Pink Copy: Rccipent Gold Copy: 0MccrAppeal nonce Rev 04/01 <br />Nanie: Last Fast Middle <br />DOB: <br />Reg. Address: City <br />State <br />Zip <br />Req, Phone: <br />Work Phone <br />- TAkay— <br />ry- <br />11 Eli 11 11 M11111111 iiffl!piigrIi� M1111 I � III <br />I!P 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 you violated Section 1 of the Park <br />and Open Space Rules, and/or Section o the Eugene Code, 1971 and/or ORS To wit, you: <br />O'he r)f 7,c 1z C' as e <br />(Description of the violation.) <br />This restriction of use b <br />I I ' I , S I and Shall reMill 1 v c u t <br />'LL 4 R ffe t a if _ <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 />JUSIVe 01 WCeK 1.7-91 <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 trom you, City personnel involved in the incident that resulted in this Notice, and other witnesses to the <br />incident. The Division Director maN exclude an%one, other than Xou and those ji s e ( I I , earin 9— <br />LLitntin% testimony, from th inf)m a h <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 a d time shown above by: <br />ti <br />(Signature of person issuing/delivering notice) <br />I hereby acknowledge receipt or the above Notice on the, date and time indicated above. <br />V7 <br />(Signature of person being issued the notice) <br />Whae Copy: Public: 'WorL Green Copy: File Yellow COPY! Repoli Copy Pink Copy: Rccipent Gold Copy: 0MccrAppeal nonce Rev 04/01 <br />