LOCATION (PARK/OPEN SPACE) cou T - MC T <br />W Entering in or using all City of Engene open spaces or facilities. <br />70 <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. 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 4'hours (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: Pubhu Wkirks Green CopC File Vollow Copy. Repoi Copy Pink Copy: Recipient Gold Copy: Officer Appea notice Rut" (4103 <br />Name: Last F I rs t Middle <br />DOB: <br />Rall <br />y <br />4, <br />Rcs. Address: City <br />Statc <br />Zip <br />Res. Phone: <br />Work Phone: <br />W Entering in or using all City of Engene open spaces or facilities. <br />70 <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. 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 4'hours (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: Pubhu Wkirks Green CopC File Vollow Copy. Repoi Copy Pink Copy: Recipient Gold Copy: Officer Appea notice Rut" (4103 <br />