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1I!jI III Iiqi� li g �ii g �I� ;l pip qg lip <br />P( Entering in or using all City of Eugene parks, open spaees or facilities. <br />M, <br />The basis for this Notice of Restriction of Use is that on you violated Section the Park <br />and Open Space Rules, and/or Section of the Eugene Code, 1971, and/or ORS To wit, vou:_ <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 />g <br />Pursuant to Park and Open Space Rule R- 1.074 you are entitled to an inforrnal 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 />I hereby acknowledge receipt of the above Notice on the date and time indicated above, <br />(Signature of person being issued the notice) <br />W hitc C opy ; Pubic Works, Green Copy, File Yellow Cory: Repon Copy Pink Copy Rccipi en GuIld Copy, 0 M o r Appeal notice Rev, 04iM <br />Name: La-4t First Middle <br />DOB: <br />Race S x� <br />CA L <br />Lw <br />Res. Address: City <br />State <br />Zip <br />Res. Phone <br />Work Phynie: <br />1I!jI III Iiqi� li g �ii g �I� ;l pip qg lip <br />P( Entering in or using all City of Eugene parks, open spaees or facilities. <br />M, <br />The basis for this Notice of Restriction of Use is that on you violated Section the Park <br />and Open Space Rules, and/or Section of the Eugene Code, 1971, and/or ORS To wit, vou:_ <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 />g <br />Pursuant to Park and Open Space Rule R- 1.074 you are entitled to an inforrnal 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 />I hereby acknowledge receipt of the above Notice on the date and time indicated above, <br />(Signature of person being issued the notice) <br />W hitc C opy ; Pubic Works, Green Copy, File Yellow Cory: Repon Copy Pink Copy Rccipi en GuIld Copy, 0 M o r Appeal notice Rev, 04iM <br />