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DATE: (st)b— lII, <br />and Notice of Right to Appeal <br />TIME: <br />CASE 4: <br />qY2 `II,( <br />11 111 11 MEN IIIII I <br />'010 Entering in or using all City of Eugene parks, open spaces or facilities. <br />(Description of the violation.) <br />This restriction of use is effective beginning on and shall remain in effect until <br />n �D <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- 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) ot'reccipt of this Notice at the following address: 1820 Roosevelt, [clvd., Eugene, OR <br />97402. <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 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, front the info al hearing. <br />']'his 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 />(Signature of person issuing/d 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 />Whitu cupy: Public Works Green Copy: File YcIlow Cvpy! Report Copy Pink Copy: Recipient Gold Copy: Officer Aplwal notice pev (U/03 <br />Nance. Last F Middle <br />DOB: <br />Race'Sex <br />q6-j <br />Res, Address: Ci ty CiFy <br />State <br />Zip <br />Res. Phonc <br />Work 1 <br />11 111 11 MEN IIIII I <br />'010 Entering in or using all City of Eugene parks, open spaces or facilities. <br />(Description of the violation.) <br />This restriction of use is effective beginning on and shall remain in effect until <br />n �D <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- 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) ot'reccipt of this Notice at the following address: 1820 Roosevelt, [clvd., Eugene, OR <br />97402. <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 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, front the info al hearing. <br />']'his 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 />(Signature of person issuing/d 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 />Whitu cupy: Public Works Green Copy: File YcIlow Cvpy! Report Copy Pink Copy: Recipient Gold Copy: Officer Aplwal notice pev (U/03 <br />