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NO TICE OF RESTRICTION OF U <br />and Notice of might to Appeal <br />D _ TIME: CASE #. <br />LOCATION (PARK/OPEN SPACE): _ _ <br />j E n t er i ng i or us a ll C o f E ugene par o pen spaces o <br />0 <br />The basis for this Notice of restriction of Use is that on m j j you violated Section of the Park <br />and Open Space Rules, and/or Section p } cthe t gene C ode, 1971, and/or SRS To wit, you. <br />(Description of the violation,) <br />This restriction of r is effective beg inning <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 />info al hearing must be made in writing and filed with the Parks & Open Space Division Director (`tithe Division Director ") <br />within 48 hours (exclusive of weekends) of receipt of this Notice at the following address. 1820 Roosevelt, Blvd., Eugene, OR <br />97 02. <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 pen 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 />(Signatt�r o person issuing delivering 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 />whrie Copy: Public Works Green Capy: File YeDow Copy: Repean Copy Pink Copy: Recipient Good Copy: Officer Appeal notice € ev. 04,103 <br />Name: Last first tv c <br />DOB: <br />Dale- c: <br />w <br />, <br />t✓ <br />x <br />ices. Address: cit <br />State <br />� <br />l) <br />i <br />Res. P hone: <br />I -------- <br />Work Phone: <br />-qev <br />j E n t er i ng i or us a ll C o f E ugene par o pen spaces o <br />0 <br />The basis for this Notice of restriction of Use is that on m j j you violated Section of the Park <br />and Open Space Rules, and/or Section p } cthe t gene C ode, 1971, and/or SRS To wit, you. <br />(Description of the violation,) <br />This restriction of r is effective beg inning <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 />info al hearing must be made in writing and filed with the Parks & Open Space Division Director (`tithe Division Director ") <br />within 48 hours (exclusive of weekends) of receipt of this Notice at the following address. 1820 Roosevelt, Blvd., Eugene, OR <br />97 02. <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 pen 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 />(Signatt�r o person issuing delivering 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 />whrie Copy: Public Works Green Capy: File YeDow Copy: Repean Copy Pink Copy: Recipient Good Copy: Officer Appeal notice € ev. 04,103 <br />