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I Entering in or using all City of Eugene parks, open spaces or facilities. <br />0 <br />The basis for this Notice of Restriction of Use is that on you violated Section I -� 0 1 of the Park <br />1 <br />and Open Space Rules, and/or Section L J , 1�1 /) of the Eugene Code. 1971, and/or ORS -. To wit, you:__k& <br />(Description of the violation.) <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. A request for an <br />F I I IN 11 <br />M' 1 1 1111 �i1H1M§flFrM`M <br />72 nourstexclusive oTwee7unus) 71 lecuiptul u1crequest. 101 IM A I urc 111i'm I 11a] I Ical mg uIr "IV Imun"In::Ukul <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 Directormay 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 dat and time shown above by-, <br />-rso I - � 1 1/deliveri ng notice) <br />(Signature of pe ssuill � <br />I hereby acknowledge receipt of the above Notice on the date and tine indicated above. <br />(Signature of person being issued the notice) <br />White Copy Pubhc Works GreenCupyi F-Ae `f chore Copy: Report Copy Pink C opyAcuipicol Gold Copv: Officer A ppeO notke Rev- 0W01 <br />Maine: Last <br />First Micidle <br />D013: <br />Racc"'Sox: <br />D V <br />cc- L A) I <br />JA"\ <br />Res. Address• <br />City <br />State <br />z'r' <br />Res. Phone' <br />Work Phone: <br />103 0-J-7 <br />. . . ....... . . ............... <br />I Entering in or using all City of Eugene parks, open spaces or facilities. <br />0 <br />The basis for this Notice of Restriction of Use is that on you violated Section I -� 0 1 of the Park <br />1 <br />and Open Space Rules, and/or Section L J , 1�1 /) of the Eugene Code. 1971, and/or ORS -. To wit, you:__k& <br />(Description of the violation.) <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. A request for an <br />F I I IN 11 <br />M' 1 1 1111 �i1H1M§flFrM`M <br />72 nourstexclusive oTwee7unus) 71 lecuiptul u1crequest. 101 IM A I urc 111i'm I 11a] I Ical mg uIr "IV Imun"In::Ukul <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 Directormay 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 dat and time shown above by-, <br />-rso I - � 1 1/deliveri ng notice) <br />(Signature of pe ssuill � <br />I hereby acknowledge receipt of the above Notice on the date and tine indicated above. <br />(Signature of person being issued the notice) <br />White Copy Pubhc Works GreenCupyi F-Ae `f chore Copy: Report Copy Pink C opyAcuipicol Gold Copv: Officer A ppeO notke Rev- 0W01 <br />