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NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />2-0c. 0 6 <br />0 TIME: CASE # <br />NC) ��k5oq <br />/�S^ 0'1Z? L17 <br />LOCATION (PARKJOPEN SPACE):_, - -j;:" I <br />T-- <br />1111 Jill 111111 11111�111�111 I I l�lill 1111111 111111111 <br />Entering in or using all City of Eugene parks, open spaces or facililli <br />e : <br />'i <br />The basis for this Notice of Restriction of Use is that on you violated Section /- of 0 of the Park <br />and Open Space Rules, andlor Section &z 4 Eugene Code, 197 1, It o re) <br />and/or ORS /1-7. <br />--� To wit, you:_ <br />(Description of the violation.) <br />This restriction of use is effective beginning on032—)/ 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. Arequestforan <br />informal hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />liviJJJ' ­ r" ug <br />my* <br />97402. <br />I L 11kitis kckcit"NIVC ul WCCKC11US) m fuLcIpt (,)I JIM: 1;:'jjL1t:'nJJ- III llt�irlllllg. t-kt mr illiurinal nearing 1 e LAMS10JI - k 01 VV H] wily <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 effect 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 />(Signature of person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />(Signature of ��person sing issued the notice) <br />White Copy: Public Works Green Copy: Fite Yellow Copy! Report Copy Pink Copy: Rccipicni Gold Copy: Officer Appeal notice Rev, 04M3 <br />Natne. Last First Ps id(fle <br />T <br />DOB: <br />R a e &SU' x <br />Res. Addr City <br />T <br />State <br />Zip <br />Res. Phone: <br />Work Phone: <br />1111 Jill 111111 11111�111�111 I I l�lill 1111111 111111111 <br />Entering in or using all City of Eugene parks, open spaces or facililli <br />e : <br />'i <br />The basis for this Notice of Restriction of Use is that on you violated Section /- of 0 of the Park <br />and Open Space Rules, andlor Section &z 4 Eugene Code, 197 1, It o re) <br />and/or ORS /1-7. <br />--� To wit, you:_ <br />(Description of the violation.) <br />This restriction of use is effective beginning on032—)/ 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. Arequestforan <br />informal hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />liviJJJ' ­ r" ug <br />my* <br />97402. <br />I L 11kitis kckcit"NIVC ul WCCKC11US) m fuLcIpt (,)I JIM: 1;:'jjL1t:'nJJ- III llt�irlllllg. t-kt mr illiurinal nearing 1 e LAMS10JI - k 01 VV H] wily <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 effect 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 />(Signature of person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />(Signature of ��person sing issued the notice) <br />White Copy: Public Works Green Copy: Fite Yellow Copy! Report Copy Pink Copy: Rccipicni Gold Copy: Officer Appeal notice Rev, 04M3 <br />