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NOTICE OF REST RICTION OF USE <br />and Notice of Right to Appeal <br />DATE. A;A 1�) TIME: 08 0, CASE # <br />� � t �� <br />LOCATION (PAR K/O PEN SPACE). <br />9 Entering in or using all City of Eugene parks, open spaces or facilities. <br />a <br />The basis for this Notice of Restriction of Use is that on you violated Section d— ojo 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 — �ay) 9 and shall rennin 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-t.074 you are entitled to an informal hearing to contest this Notice, Arequest 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 ho (exclusive of weekends) of receipt of this Notice at the following address: 1820 Roosevelt, Blvd ®, Eugene., OR <br />97402. <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 />White Copy: Pubfi c Wozks Green Copy! File Yellow Copy: Rsport Copy Nink Copy Reciplient (jolt! Copy� Officer Appeal nonce Rev. 04,03 <br />Name: Lal;,t First Middle <br />DCPB <br />Rrice"s <br />ti Lo- 1DY-74/--'j <br />C 1 1) ti <br />Ill 7A, k <br />E w <br />Res. Addr City <br />Stag <br />Zip Zip <br />Res, Phone: <br />Work Phone: <br />9 Entering in or using all City of Eugene parks, open spaces or facilities. <br />a <br />The basis for this Notice of Restriction of Use is that on you violated Section d— ojo 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 — �ay) 9 and shall rennin 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-t.074 you are entitled to an informal hearing to contest this Notice, Arequest 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 ho (exclusive of weekends) of receipt of this Notice at the following address: 1820 Roosevelt, Blvd ®, Eugene., OR <br />97402. <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 />White Copy: Pubfi c Wozks Green Copy! File Yellow Copy: Rsport Copy Nink Copy Reciplient (jolt! Copy� Officer Appeal nonce Rev. 04,03 <br />