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III 11pi iiiiiiiiiiii 1111111 I'll !1' 1111111111 111111 ISO! <br />I mom <br />—,�K 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 — Mt, you violated Section X14) of the Park <br />and Open Space Rules, and/or Section 4 -J'L�AO of the Eugene Code, 1971, and/or ORS —. To wit, you <br />SY V-113 I <br />(Description a F 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 Noficc A request for an <br />informal hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Directoe) <br />w i th i n 4 IM <br />97402. <br />The Division Director shall schedule a time and place For the infor 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 />(j t2 <br />(Signature of person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />Name Last First Midffle <br />DOB: <br />Race.,"ex: <br />MOV11- I 71 AjFt OL <br />................... <br />35 os / so� <br />11-� <br />Res. Mdress: Cit <br />dip <br />Res- Phone: <br />Work Phone: <br />1� 7 1-� QLZ cz Ls, <br />qzc, J��, -0-w <br />- <br />III 11pi iiiiiiiiiiii 1111111 I'll !1' 1111111111 111111 ISO! <br />I mom <br />—,�K 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 — Mt, you violated Section X14) of the Park <br />and Open Space Rules, and/or Section 4 -J'L�AO of the Eugene Code, 1971, and/or ORS —. To wit, you <br />SY V-113 I <br />(Description a F 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 Noficc A request for an <br />informal hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Directoe) <br />w i th i n 4 IM <br />97402. <br />The Division Director shall schedule a time and place For the infor 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 />(j t2 <br />(Signature of person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />