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NOTICE OF.RESTRICT[ON OF USE <br />and Notice of Right to Appeal <br />DATE: <br />LOCAT2 <br />1"MMIM 1 4 1 " M <br />Entering in or using all City of Eugene parks, open spaces or facilitie <br />C <br />The basis for this Notice of Restriction of Use is that on you violated Section 0 lq � <br />_�o F the Park <br />and Open Space Rules, and/or Section L ) . 0 of the Eugene Code, 1971, and/or ORS To wit, you: <br />X <br />�A ff�U�� it Mo I �L I UUUIPL U I MIJ I � V Ll�s, UL MU 14L—W 1] 16 U%­". A U�T ��w',z6c .;Av <br />97402. <br />4 01"le reqVITIT 7or Melling. At me VM <br />consider testimony from you, City personnel involved in the dent, 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 effcTt pending any requested hearing. <br />This Notice of Exclusion was delivered to the person named at the top of this Notice at the date and time shown above by <br />(Sign Atitre ol'perst)n�'IssLiin /delivering'iioticc <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />J - Z n En <br />(Signature ol'person being issued the notice) <br />While Copy: Public Works Green Copy: File Yellow Copy: Report Copy Pink Copy: Recipient G ol d Copy: Officer A ppei I notice Rcv 04/03 <br />Name: Last First Middle <br />DOB: <br />Rae e./Sex� <br />WhA <br />Res. Address: Ci <br />State <br />Zip <br />Res, Phone: <br />WOTk Phone: <br />1"MMIM 1 4 1 " M <br />Entering in or using all City of Eugene parks, open spaces or facilitie <br />C <br />The basis for this Notice of Restriction of Use is that on you violated Section 0 lq � <br />_�o F the Park <br />and Open Space Rules, and/or Section L ) . 0 of the Eugene Code, 1971, and/or ORS To wit, you: <br />X <br />�A ff�U�� it Mo I �L I UUUIPL U I MIJ I � V Ll�s, UL MU 14L—W 1] 16 U%­". A U�T ��w',z6c .;Av <br />97402. <br />4 01"le reqVITIT 7or Melling. At me VM <br />consider testimony from you, City personnel involved in the dent, 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 effcTt pending any requested hearing. <br />This Notice of Exclusion was delivered to the person named at the top of this Notice at the date and time shown above by <br />(Sign Atitre ol'perst)n�'IssLiin /delivering'iioticc <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />J - Z n En <br />(Signature ol'person being issued the notice) <br />While Copy: Public Works Green Copy: File Yellow Copy: Report Copy Pink Copy: Recipient G ol d Copy: Officer A ppei I notice Rcv 04/03 <br />