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NOTICE OF RESTRICTION OF USE <br />DATE: <br />LOCATION (PARK-/OPEN SPACE): LAJ <br />and Notice of Right to Appeal <br />TIME: <br />V1 <br />N <br />CASE #- A5-- <br />I'll, I I � 11111 <br />13 7 �'1711 Is I 11pligull i 1q , 11111plill! gliplipill;'11111pill 'I I <br />Flittering in or using all City of Eugene parks, open spaces or facilities. <br />W <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 />The Division Director shall schedule a time and place for the informal hearing to be conducted, which shall be not more than <br />72 hours (exclusive of'weckends) of receipt ofthe request for hearing. At the informal hearing the Division Director will only <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 in Pon 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 thi, ove by: <br />(Signature ofperson issuing/dehvering notice) <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: Public Works 6yeen Copy: File V eltow C opy: Report Copy Pink Copy: Recipient Gold Copy: Officer Appeal nofice Rm 04W <br />;z <br />Nanie Last t Middle <br />DOB: <br />k: <br />A- C - ---------- AAJ" <br />CR ) <br />K-) <br />c_1 <br />R Address: S Adss: City <br />State <br />Zip <br />Res. Phone: <br />Work Phone: <br />_ 0 <br />I'll, I I � 11111 <br />13 7 �'1711 Is I 11pligull i 1q , 11111plill! gliplipill;'11111pill 'I I <br />Flittering in or using all City of Eugene parks, open spaces or facilities. <br />W <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 />The Division Director shall schedule a time and place for the informal hearing to be conducted, which shall be not more than <br />72 hours (exclusive of'weckends) of receipt ofthe request for hearing. At the informal hearing the Division Director will only <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 in Pon 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 thi, ove by: <br />(Signature ofperson issuing/dehvering notice) <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: Public Works 6yeen Copy: File V eltow C opy: Report Copy Pink Copy: Recipient Gold Copy: Officer Appeal nofice Rm 04W <br />