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NOTICE OF RESTRICTION OF USE <br />DATE: <br />LOCATION (PARK/OPEN SPACE): <br />and Notice of Right to Appeal <br />TIME: I 5S <br />M <br />III I I � 111111111 111111 111 111 11 111 11 iIii!llilli ii 10 iiiiiii 1 i 1 9 111 1 � III I � I III I I <br />Entering in or using all City of Eugene parks, open spaces or facilities. <br />0 <br />(Description of the violation.) <br />This restriction of use is effective beginning on 6t)Z 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 infornial hearing to contest this Notice. Arequest 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 info al 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 />C�) <br />(Signature of person issuing/ slivering 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 />While Copy: Public Works Green Copy: File Yellow Copy: Report Copy Pink Copy: Recipient Gold Copy: Officer Appeal notice k ()4!pj <br />Name: First Middle <br />DOB <br />Rac /S A' <br />Res. Address: City <br />State <br />Zip <br />Res. Phone: <br />Work Phone: <br />III I I � 111111111 111111 111 111 11 111 11 iIii!llilli ii 10 iiiiiii 1 i 1 9 111 1 � III I � I III I I <br />Entering in or using all City of Eugene parks, open spaces or facilities. <br />0 <br />(Description of the violation.) <br />This restriction of use is effective beginning on 6t)Z 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 infornial hearing to contest this Notice. Arequest 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 info al 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 />C�) <br />(Signature of person issuing/ slivering 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 />While Copy: Public Works Green Copy: File Yellow Copy: Report Copy Pink Copy: Recipient Gold Copy: Officer Appeal notice k ()4!pj <br />