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111 1 1111 1117 111111 <br />1 1 lig 1 11' <br />,;�R Entering in or usingall City of Eugene parks, open spaces or facilities. <br />X <br />The basis for this Notice of Restriction of Use is that on 1411 ( 11 1 ;_� you violated Section W of The Park <br />(Description of the violation.) <br />1_ <br />This restriction of use is effective beginning on qVL _ — , and shall remain in effect until 441 <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 infon-nal 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 hour% (excl u%ive of weekends) of recei nt of thi q Vatic-,ent th P, followin address - I <br />1Vd__ Fnapit",-M <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 oft e request for hearing. At the infonnal 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 />It <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 />WhiLe Copy. Public Works Green copy: File Yellow Copy Report Copy Pink Copy: Recipient Gold Copy: Officer Appeal notice Pey, 04,103 <br />N4me: Last First Middle <br />DOB <br />Race"Sex- <br />C <br />Res, Address-, City <br />State <br />Zip <br />Res. Phone: <br />Work Phone: <br />111 1 1111 1117 111111 <br />1 1 lig 1 11' <br />,;�R Entering in or usingall City of Eugene parks, open spaces or facilities. <br />X <br />The basis for this Notice of Restriction of Use is that on 1411 ( 11 1 ;_� you violated Section W of The Park <br />(Description of the violation.) <br />1_ <br />This restriction of use is effective beginning on qVL _ — , and shall remain in effect until 441 <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 infon-nal 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 hour% (excl u%ive of weekends) of recei nt of thi q Vatic-,ent th P, followin address - I <br />1Vd__ Fnapit",-M <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 oft e request for hearing. At the infonnal 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 />It <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 />WhiLe Copy. Public Works Green copy: File Yellow Copy Report Copy Pink Copy: Recipient Gold Copy: Officer Appeal notice Pey, 04,103 <br />