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NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />DATE: — CtA Ll��k riME: A CASE <br />— �-- <br />LOCATION (PARKJOPEN SPACE): <br />W <br />111111 111 1111111 i 11111 ;� riiii�� 1111 19 1111 li�'ll, ''Ill, ip� 11111 11111 �!111111p"' 11 1 <br />Entering in or using all City of Eugene parks, open spaces or facilifies. <br />The basis for this Notice of Restriction of Use is that on —Zq2 , you violated Section of the Park <br />and Open Space Rules, and/or Section of the Eugene Code, 1971, and/or ORS —KsTo wit, you.-_ <br />(Description of the violation.) <br />This restriction of use is effective beginning on and shall rearm nlea 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 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 />The Division Director shall schedule a time and place for the inrormal hearing to be conducted, which shall be not more than <br />72Jmu*li-�i <br />consider testimony frorn 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, ftom the informal hearing. <br />This Notice shall remain in effeet 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 />(Signature of person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />NP <br />(Signature of person being issued the notice) <br />Wha Copy: Publw Works Green Copy: File Yellow Copy: Report Copy Pink Copy: RLvipicnt Gold Copy: Offices Appeal notice Rev- 04-103 <br />Nance: t First Muldle <br />Q ` 71Q U <br />00 B <br />kaee/sex� <br />Res. Address: City <br />El= <br />State <br />Pip <br />Res, Phone: <br />Work Phone: <br />111111 111 1111111 i 11111 ;� riiii�� 1111 19 1111 li�'ll, ''Ill, ip� 11111 11111 �!111111p"' 11 1 <br />Entering in or using all City of Eugene parks, open spaces or facilifies. <br />The basis for this Notice of Restriction of Use is that on —Zq2 , you violated Section of the Park <br />and Open Space Rules, and/or Section of the Eugene Code, 1971, and/or ORS —KsTo wit, you.-_ <br />(Description of the violation.) <br />This restriction of use is effective beginning on and shall rearm nlea 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 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 />The Division Director shall schedule a time and place for the inrormal hearing to be conducted, which shall be not more than <br />72Jmu*li-�i <br />consider testimony frorn 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, ftom the informal hearing. <br />This Notice shall remain in effeet 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 />(Signature of person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />NP <br />(Signature of person being issued the notice) <br />Wha Copy: Publw Works Green Copy: File Yellow Copy: Report Copy Pink Copy: RLvipicnt Gold Copy: Offices Appeal notice Rev- 04-103 <br />