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NOTICE OF RESTRICTION OF USE 5 0 �54 oA <br />DATE: <br />and Notice of Right to Appeal <br />TIME. 1 CASE #: <br />LOCATION (PARK/OPEN SPACE), <br />A <br />IZMIR! <br />/00 Entering in or using all City of Eugene parks, open spaces or facilities. <br />0 <br />The basis for this Notice of Restriction of Use is that on ( , you violated Section "1 0 k4Y� the Park <br />and Open Space Rules, andi Section Z�P of the Eugene Code, 1971,and /or ORS ---- To wit, you: <br />(Description of the violation.) <br />This restriction of use is effective beginning on (S 4 ll 1 b, and shall remain in effect until 05WE? <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 />.......... <br />97402. <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 rernain 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 />li- '-'AR�j <br />(Sig issuing / ' <br />delivering ture of person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above, <br />(Signature o person being issued the notice) <br />White Copy: Public Work, Green Copy! File Yellow Cupy: Report Copy Pink Copy: Rmlptenl Gatcl Copy; Officer Appeal notice Rev- 0443 <br />Namc. Last First Middle <br />D - OB: <br />R "'S . ex : <br />�' " �' ' ' ' <br />z <br />Ll� <br />— <br />t Al <br />Res. Address: City <br />State Zip <br />Res, Pfione� <br />Work Phone: <br />IZMIR! <br />/00 Entering in or using all City of Eugene parks, open spaces or facilities. <br />0 <br />The basis for this Notice of Restriction of Use is that on ( , you violated Section "1 0 k4Y� the Park <br />and Open Space Rules, andi Section Z�P of the Eugene Code, 1971,and /or ORS ---- To wit, you: <br />(Description of the violation.) <br />This restriction of use is effective beginning on (S 4 ll 1 b, and shall remain in effect until 05WE? <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 />.......... <br />97402. <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 rernain 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 />li- '-'AR�j <br />(Sig issuing / ' <br />delivering ture of person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above, <br />(Signature o person being issued the notice) <br />White Copy: Public Work, Green Copy! File Yellow Cupy: Report Copy Pink Copy: Rmlptenl Gatcl Copy; Officer Appeal notice Rev- 0443 <br />