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LOCATION (PAR /OPEN SPACE): f --r ,# 5 J­M�oycL-,) A4 <br />W <br />IN 1 1171 1111 1, 11711111 I'll, "I � jil Ippip!1I 111!1 g! 11 gip''Jig 1111111 Ip I F III � <br />W Entering in or using all City of Eugene parks, open spaces or faciliticl <br />o <br />The basis for this Notice of Restriction of Use is that on cYV4C violated Section /-Cjlc ' of the Park <br />and Open Space Rules, and/or Section P � X of the Eugene Code, 1971, and/or ORS To wit, you <br />L_j <br />(Description of the violation.) <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 />97401 <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 inter al hearing, <br />This Notice shall reuiain in effect pending any requested hearing. <br />This Notice ot'Exclusion was delivered to the person named at the top ofthis Notice at the date and time shown above by: <br />fiJi'k <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 />White copy: Pub] IV works Green Copy: Fik Yellow Copy: Report Copy Pink Copy: Reclpicnt Gold Cupy: Officcr ..p al notice Rtev, 04103 <br />Name: Last 'WL First Middle <br />DOR <br />Race/Sex: <br />Res. Address: i <br />10 <br />Zip <br />Res. Phone: <br />Work phone: <br />=1 <br />IN 1 1171 1111 1, 11711111 I'll, "I � jil Ippip!1I 111!1 g! 11 gip''Jig 1111111 Ip I F III � <br />W Entering in or using all City of Eugene parks, open spaces or faciliticl <br />o <br />The basis for this Notice of Restriction of Use is that on cYV4C violated Section /-Cjlc ' of the Park <br />and Open Space Rules, and/or Section P � X of the Eugene Code, 1971, and/or ORS To wit, you <br />L_j <br />(Description of the violation.) <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 />97401 <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 inter al hearing, <br />This Notice shall reuiain in effect pending any requested hearing. <br />This Notice ot'Exclusion was delivered to the person named at the top ofthis Notice at the date and time shown above by: <br />fiJi'k <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 />White copy: Pub] IV works Green Copy: Fik Yellow Copy: Report Copy Pink Copy: Reclpicnt Gold Cupy: Officcr ..p al notice Rtev, 04103 <br />