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NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />DA TIME: �U-G CASE #: <br />LOCATION (PARKJOPEN SPACE): <br />516 Entering in or using all City of Eugene parks, open spaces or facilities, <br />The basis for this Notice of Restriction of Use is that on , you the Park <br />violated Section <br />and Open Space Rules-, and/or Section of the Eugene Code, 1971, and/or CIRS <br />... 7 To wit, you:_ <br />(Description of the violation.) <br />This restriction of use is effective beginning on 0 is and shall remain in effect unfilo-5 IS <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 />i - rifion 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 Roogevelt, Blvd., Eugene, OR <br />97402. <br />T lie Division Director shall schedule a time and place for the infort 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 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 />(Sicnature of person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />-k Qef��b - ­ - <br />(Signature of person being issued the notice) <br />White Cupy: Pub Work s Grem Copy: File Yellow Copy: Report Copy Pink Copy: Rq�cipient GoM Copy. Officer Appeal not so, Rev- OV03 <br />Nan)e- Last First Middle <br />-4 <br />DOB: <br />R a c c is�e � � <br />Re A iryss� city <br />state <br />zip <br />Res. Phone: <br />Work Phoney <br />UGIJ <br />0 <br />516 Entering in or using all City of Eugene parks, open spaces or facilities, <br />The basis for this Notice of Restriction of Use is that on , you the Park <br />violated Section <br />and Open Space Rules-, and/or Section of the Eugene Code, 1971, and/or CIRS <br />... 7 To wit, you:_ <br />(Description of the violation.) <br />This restriction of use is effective beginning on 0 is and shall remain in effect unfilo-5 IS <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 />i - rifion 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 Roogevelt, Blvd., Eugene, OR <br />97402. <br />T lie Division Director shall schedule a time and place for the infort 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 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 />(Sicnature of person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />-k Qef��b - ­ - <br />(Signature of person being issued the notice) <br />White Cupy: Pub Work s Grem Copy: File Yellow Copy: Report Copy Pink Copy: Rq�cipient GoM Copy. Officer Appeal not so, Rev- OV03 <br />