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NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />DATE: 3PJJ—Li�— TIME: CASE <br />zms�svu5i� <br />LOCATION (PARK/0PEN SPACE)-,—Acng—ARK-�t� t, <br />Entering in or using all City of Eugene parks, open spaces or facilities. <br />The basis for this Notice o Restriction o Use is that on t you violated Section LTS-011-0 of the Park <br />and Open Space Rules, and/or Section of the Eugene Code, 1971, and/or ORS To wit, you.- V <br />�JD - ALI �Js <br />This restriction of use is effective beginning on N' 41s- and shall remain in effeet until VILPY--m <br />If you enter in or use any City of Eugene park-, open space or Cacility 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 R ule R - you are entitled to an informal hearing to contest this No tice. A request ror an <br />in Fonnal hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Director') <br />within 48 hours (exclusive ol'weekends) of receipt of this Notice at the following address: 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />12, nours (exclusive of weeKonus) of receipt oi Me Tequcsf for nearing. At mv Hearing in Division <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 effert pending any requested hearing. <br />This Notice of Exclusion was delivered to the person named at the top or this Not the date and time shown above by: <br />re of'person issuing <br />�Si ' I;� _ imi•e) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />IJ <br />(Signature of person being issued the notice) <br />Whitu Copy: Public Works Green Copy: File Ycl hm Copy: Repori C upy Pink C o pyy Re ip icni Gaid Copy: CH&:er Appcaf notice Rev- 04iffl <br />Naine: Last First Middle <br />DOH: <br />Raee/Sex� <br />C �17 <br />f Z e s - AA d d r e sLs: City <br />State <br />tat, <br />�Zj, P � <br />Rc%. Phon <br />'ork Phone! <br />Entering in or using all City of Eugene parks, open spaces or facilities. <br />The basis for this Notice o Restriction o Use is that on t you violated Section LTS-011-0 of the Park <br />and Open Space Rules, and/or Section of the Eugene Code, 1971, and/or ORS To wit, you.- V <br />�JD - ALI �Js <br />This restriction of use is effective beginning on N' 41s- and shall remain in effeet until VILPY--m <br />If you enter in or use any City of Eugene park-, open space or Cacility 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 R ule R - you are entitled to an informal hearing to contest this No tice. A request ror an <br />in Fonnal hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Director') <br />within 48 hours (exclusive ol'weekends) of receipt of this Notice at the following address: 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />12, nours (exclusive of weeKonus) of receipt oi Me Tequcsf for nearing. At mv Hearing in Division <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 effert pending any requested hearing. <br />This Notice of Exclusion was delivered to the person named at the top or this Not the date and time shown above by: <br />re of'person issuing <br />�Si ' I;� _ imi•e) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />IJ <br />(Signature of person being issued the notice) <br />Whitu Copy: Public Works Green Copy: File Ycl hm Copy: Repori C upy Pink C o pyy Re ip icni Gaid Copy: CH&:er Appcaf notice Rev- 04iffl <br />