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NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />DATE: TIME: X 9 CASE <br />N<� � t�l, �%� <br />LOCATION (PARK/OPEN SPACE): <br />I IF 1 ► <br />11 l�'Illil 11 1 i <br />7—we <br />t a gene parks, open spaces or facilities. <br />The basis for this Notice of Restriction of Use is that on _Qy uGy- _, you violated Section /,Oiu 00 of the Park <br />and Open Space Rules, and/or Section _R, U? _j_ of the Eugene Code, 1971, and/or 0 RS --- . ..... --. To wit, you. <br />(Description of the violation.) <br />This restriction of use is effective beginning on CO�L5V and shall remain in effect until OLS7���� <br />If yore. 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 49 hours (exclusive of weekends) of receipt of this Notice at the following address: 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />uOm h tuxl:, nus) 01 lck. ul II mqucz�L 101 11callne". 1-MITUMI Will 15111V <br />consider testimony frorn you, City personnel involved in the incident that resulted in this Notice, and other witnesses to t�e <br />incident. The D ivisdon 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 />("El q-/ qC11 <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! PuI Work's, CI Copy: Fihe Yellow Copy: Report Copy Pin Copy. Recipient Gold Copv� 0f ni�r A gra notice Rev- 93 103 <br />Name� Last First Middle <br />DOB <br />Kace,'Sqx� <br />151 <br />Res, Address City <br />Zip <br />Res. Phone: <br />Work Phone: <br />I IF 1 ► <br />11 l�'Illil 11 1 i <br />7—we <br />t a gene parks, open spaces or facilities. <br />The basis for this Notice of Restriction of Use is that on _Qy uGy- _, you violated Section /,Oiu 00 of the Park <br />and Open Space Rules, and/or Section _R, U? _j_ of the Eugene Code, 1971, and/or 0 RS --- . ..... --. To wit, you. <br />(Description of the violation.) <br />This restriction of use is effective beginning on CO�L5V and shall remain in effect until OLS7���� <br />If yore. 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 49 hours (exclusive of weekends) of receipt of this Notice at the following address: 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />uOm h tuxl:, nus) 01 lck. ul II mqucz�L 101 11callne". 1-MITUMI Will 15111V <br />consider testimony frorn you, City personnel involved in the incident that resulted in this Notice, and other witnesses to t�e <br />incident. The D ivisdon 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 />("El q-/ qC11 <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! PuI Work's, CI Copy: Fihe Yellow Copy: Report Copy Pin Copy. Recipient Gold Copv� 0f ni�r A gra notice Rev- 93 103 <br />