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NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />DATE: TIME: i 205- CASE # <br />`��1 <br />LOCATION (PA ` SPACE): 61 <br />v,,jtV-6Z,5j?V j7Af4 I- <br />�y 0 M I n I s t ra n ve 0 o. ancrfTrZand open YOU are herehv <br />notified that you are prohibited from (check box): <br />7*1 <br />The basis for this Notice of Restriction of Use is that on cx507)r/i1cC you violated Section 4-0-71 ofthe Park <br />and Open Space Rules, and/or Section _ of the Eugene Code, 1471, and/or ORS --. To wit, you <br />-- vict— eA2Z /Zjcc;,� LA 6�< /19AJ <br />(Description of 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 Notice. Arequest for an <br />info al 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 informal hearing to be conducted, which shall be not more than <br />72 hours f exclusive of weekends, of receiott of the re2tuest for hearinWkl thi� informal hearin, thr- Division Dirnc or wi-11 waily <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 />� ature oFpe <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />(5( ' nature o person being issued the notice) <br />White Copy: Public Works Green Copy: Fite Yellow CopC Report Copy Pink Copy Recipient Gold Cosy: Officer Appeal notice Rev. 04,03 <br />Name: Last First Middle <br />DOB: <br />Race/Sex; <br />E <br />u. <br />TU00) e RiZA <br />17-12- <br />C. <br />Res, Address: city <br />te <br />Zip <br />Res. Phone: <br />Work Phone: <br />f <br />Z�U <br />l <br />ef - <br />4 —y <br />I 100L <br />R <br />�y 0 M I n I s t ra n ve 0 o. ancrfTrZand open YOU are herehv <br />notified that you are prohibited from (check box): <br />7*1 <br />The basis for this Notice of Restriction of Use is that on cx507)r/i1cC you violated Section 4-0-71 ofthe Park <br />and Open Space Rules, and/or Section _ of the Eugene Code, 1471, and/or ORS --. To wit, you <br />-- vict— eA2Z /Zjcc;,� LA 6�< /19AJ <br />(Description of 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 Notice. Arequest for an <br />info al 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 informal hearing to be conducted, which shall be not more than <br />72 hours f exclusive of weekends, of receiott of the re2tuest for hearinWkl thi� informal hearin, thr- Division Dirnc or wi-11 waily <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 />� ature oFpe <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />(5( ' nature o person being issued the notice) <br />White Copy: Public Works Green Copy: Fite Yellow CopC Report Copy Pink Copy Recipient Gold Cosy: Officer Appeal notice Rev. 04,03 <br />