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NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />DATE: TIME: 1 - a (�D CASE #- <br />LOCATION (PARK/OPEN SPACE): <br />1 5 - '3DO'D- <br />o') I r- 1 11, 0 rat? L( <br />[W 1'11"V =I 713". 11711 1 1 111 1 1 111 1 1 1 111 1 1 1 1111 1 1 1 1 Iffigil <br />�O 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 you violated Section of the Park <br />and Open Space Rules, and/or Section L(—A-6-L14 the Eugene Code, 1971, and/or ORS TO wit, you:_ <br />---- � <br />(Description of the violation.) <br />This restriction of use is effective beginning on 05\5 6, 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. A request for an <br />inforinal 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 />-JIV161ull 1 fluCtTUTI JIULlule a thIM-I U 11110illial nrldillig LU M LULIUMMU, L 111011V Man <br />72 hours (exclusive of weekends) of receipt of the request for hearing, At the infort 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 />(Signature ofperson issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above, <br />(Signature 0 being issued the notice) <br />While Copy: Public works Green Copy: File Yellow Copy! Report Copy Pink Copy: Recipient Gold Copy: Officer Appeal notice Rev, 04/03 <br />N L< a First Middle <br />DOB: <br />1 Race/sex: <br />c <br />L'A' <br />Res. Address: City <br />State <br />Zip <br />Res, Phone; <br />Work Phone; <br />[W 1'11"V =I 713". 11711 1 1 111 1 1 111 1 1 1 111 1 1 1 1111 1 1 1 1 Iffigil <br />�O 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 you violated Section of the Park <br />and Open Space Rules, and/or Section L(—A-6-L14 the Eugene Code, 1971, and/or ORS TO wit, you:_ <br />---- � <br />(Description of the violation.) <br />This restriction of use is effective beginning on 05\5 6, 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. A request for an <br />inforinal 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 />-JIV161ull 1 fluCtTUTI JIULlule a thIM-I U 11110illial nrldillig LU M LULIUMMU, L 111011V Man <br />72 hours (exclusive of weekends) of receipt of the request for hearing, At the infort 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 />(Signature ofperson issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above, <br />(Signature 0 being issued the notice) <br />While Copy: Public works Green Copy: File Yellow Copy! Report Copy Pink Copy: Recipient Gold Copy: Officer Appeal notice Rev, 04/03 <br />