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NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />DATE: t llql, 1, <br />LOCATION (PARK/OPEN SPACE) <br />TIME: CASE #: <br />13 <br />l�11,11�ilill 1 1111111111 1 111111111 I 11111 1111111111 1111 p <br />M <br />The basis for this Notice of Restriction of Use is that on you violated Section / V/ 0 the Park <br />and Open Space Rules, and/or Section )�01 0 1 of the Eugene Code, 1971, and/or ORS -. To wit, you:_ <br />(AP <br />(Description of the violation.) <br />This restriction of use is effective beginning on and shall 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 Noticc. 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 ofthis Notice at the following address: 1820 Roosevelt, Blvd., 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 />White Copy: Public Works Green Copy: File Yellow C upy: Repovt Copy Pink Copy: Recipient Gold Copy; Offlucr Appeal nouce Rev- 04,'03 <br />Natne Last First Middle <br />DOB: <br />SQX: <br />7 <br />wg, <br />Res. Address: city <br />State: <br />Zi p <br />Zip r <br />Re Phone: <br />Work Phone: <br />- f )X-f <br />l�11,11�ilill 1 1111111111 1 111111111 I 11111 1111111111 1111 p <br />M <br />The basis for this Notice of Restriction of Use is that on you violated Section / V/ 0 the Park <br />and Open Space Rules, and/or Section )�01 0 1 of the Eugene Code, 1971, and/or ORS -. To wit, you:_ <br />(AP <br />(Description of the violation.) <br />This restriction of use is effective beginning on and shall 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 Noticc. 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 ofthis Notice at the following address: 1820 Roosevelt, Blvd., 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 />White Copy: Public Works Green Copy: File Yellow C upy: Repovt Copy Pink Copy: Recipient Gold Copy; Offlucr Appeal nouce Rev- 04,'03 <br />