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fl <br />DATE: — TIME: CASE <br />LOCATION (PARK,OPE SPACE): <br />Under the authorit Administrative Ord N and P arkand Open Space Rule R-1.005(3), you are hereby <br />notified that you are proh <br />E ntering 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, andlor Section AA-0 of the Eugene Code, 1971, and /or OR �. To wit, you: <br />(Description of the violation.) <br />This restriction of use is effective beginning an D a_ �� I 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 cri trespass in the second degree. <br />Pursuant to Park and Open Space Rule R -1 .074 you are entitled to an info al hearing to contest this Notice. A request fear an <br />informal hearing must be made in writing and filed with the Parks & (open Space Division [director ( "the Division Director ") <br />within 49 hours (exclusive of weekends) of receipt of this Notice at the following address: 1820 Roosevelt, Blvd,, Eugene, OR <br />97402. <br />p ending 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 t;' d <br />This Notice of Exclusion was delivered to the person named at the top ofthis'Jotice LIale and tune shovvii above by: <br />of person issuing /delivering notice) <br />I hereby acknowledge receipt of the above Notice can the date and time <br />White Capy: Public works Green Copy: File Yellow Copy: Report Copy Pink Copy: Recipient Cold Copy: Officer Appeal notice Rey,% 04103 <br />Name: Last First Middle <br />DOB: <br />Race /Sex: <br />fi . <br />pq <br />:J <br />Res. Address: City <br />f <br />State <br />Zip <br />Res. Phone: <br />Work Phone: <br />a y <br />Under the authorit Administrative Ord N and P arkand Open Space Rule R-1.005(3), you are hereby <br />notified that you are proh <br />E ntering 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, andlor Section AA-0 of the Eugene Code, 1971, and /or OR �. To wit, you: <br />(Description of the violation.) <br />This restriction of use is effective beginning an D a_ �� I 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 cri trespass in the second degree. <br />Pursuant to Park and Open Space Rule R -1 .074 you are entitled to an info al hearing to contest this Notice. A request fear an <br />informal hearing must be made in writing and filed with the Parks & (open Space Division [director ( "the Division Director ") <br />within 49 hours (exclusive of weekends) of receipt of this Notice at the following address: 1820 Roosevelt, Blvd,, Eugene, OR <br />97402. <br />p ending 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 t;' d <br />This Notice of Exclusion was delivered to the person named at the top ofthis'Jotice LIale and tune shovvii above by: <br />of person issuing /delivering notice) <br />I hereby acknowledge receipt of the above Notice can the date and time <br />White Capy: Public works Green Copy: File Yellow Copy: Report Copy Pink Copy: Recipient Cold Copy: Officer Appeal notice Rey,% 04103 <br />