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NOTICE, OF RESTRICTION OF USE c bp�A l llo o \ I <br />DATE: 3 <br />b—dw�-- <br />and Notice of Right to Appeal <br />1 IME: CA SE #: <br />LOCATION( PARKJOPEN SPACE): ��, Ax <br />R Entering in or using all City of Eugene parks, open spaces or facilities.. <br />x <br />The basis for this Notice of Restriction of Use is that on —J-T—avhz�—, you violated Section 11 01d--, f the Park <br />and Open Space R ales, and/or Section of the Eugene Code, 171, and/or OR S —. To wit, you:_ <br />(Description of the violation,) <br />This restriction of use is effective beginning on card , ,hall 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 />informal bearing must be made: in writing and filed with the Parks & Open Space Division Direetor ("the Division Director") <br />within 48 hours (exclusive of weekends) of receipt of this Notice at the following address: 1820 Roosevelt, Bivd., Eugene, OR <br />97402. <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 />Whac Copy: Public Works Green Copy: File yellow ( upy ; k Lqsoet Copy Pink Copy: Recipient Gold Copy: Offlicer Appeal notice Rev- 04,103 <br />Nance: Last First Middle <br />DOB. <br />Race"Sex <br />ZA:L <br />Res. Addres City <br />State <br />Zip <br />Res, Phone: <br />Work Phone: <br />R Entering in or using all City of Eugene parks, open spaces or facilities.. <br />x <br />The basis for this Notice of Restriction of Use is that on —J-T—avhz�—, you violated Section 11 01d--, f the Park <br />and Open Space R ales, and/or Section of the Eugene Code, 171, and/or OR S —. To wit, you:_ <br />(Description of the violation,) <br />This restriction of use is effective beginning on card , ,hall 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 />informal bearing must be made: in writing and filed with the Parks & Open Space Division Direetor ("the Division Director") <br />within 48 hours (exclusive of weekends) of receipt of this Notice at the following address: 1820 Roosevelt, Bivd., Eugene, OR <br />97402. <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 />Whac Copy: Public Works Green Copy: File yellow ( upy ; k Lqsoet Copy Pink Copy: Recipient Gold Copy: Offlicer Appeal notice Rev- 04,103 <br />