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JIF I! I I I I III I I � I III I III I I <br />El <br />The basis for this Notice of Restriction of Use is that on _jpyo Section <br />Lq iS of the Park <br />you violated <br />(Description of the violation.) <br />This restriction of use is effective beginning on <br />J/ 5' , and shall remain in effect until CILC <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 hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />within 48 hours (exclusive of weekends) of receipt of this Notice at the following address: 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <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 weekends) of receipt of the 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 informal hearing. <br />This Notice shall remain in effect pending any requested bearing. <br />This Notice of Exclusion was delivered to the person named at the top of this Notice at the date and W 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 being issued the notice) <br />Whac Copy: Public Works Gtccn Copy� File YcIlmy Copy: Stepan Copy Pink Copy: Recipient 6old Copy: 0M c � r A ppcu [ noti Rev- fW03 <br />Name- Last First Middle <br />DOB: <br />Rnee,S <br />6 <br />Res. A ddress: City <br />State <br />Zip <br />Res. Mont: <br />Work Phone: <br />JIF I! I I I I III I I � I III I III I I <br />El <br />The basis for this Notice of Restriction of Use is that on _jpyo Section <br />Lq iS of the Park <br />you violated <br />(Description of the violation.) <br />This restriction of use is effective beginning on <br />J/ 5' , and shall remain in effect until CILC <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 hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />within 48 hours (exclusive of weekends) of receipt of this Notice at the following address: 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <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 weekends) of receipt of the 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 informal hearing. <br />This Notice shall remain in effect pending any requested bearing. <br />This Notice of Exclusion was delivered to the person named at the top of this Notice at the date and W 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 being issued the notice) <br />Whac Copy: Public Works Gtccn Copy� File YcIlmy Copy: Stepan Copy Pink Copy: Recipient 6old Copy: 0M c � r A ppcu [ noti Rev- fW03 <br />