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I'l � n5 <br />NOTICE OF RESTRICTION OF USE b A <br />and Notice of Right to Appeal INR <br />DATE: osicais TIME: 9 CASE ft <br />�i <br />LOCATION (PARK/OPEN SPACE): HAi;- <br />' <br />1 111 1 11111111111111111! Illp I I! I!Il III! I i Ili I I <br />The basis for this Notice of Restriction of Use is that on o <br />you violated Section — 1 , ( 90( o ' the Park <br />and Open Space Rules, arl Section _ "� of the Eugene Code, 1971 and/or ORS — 1 To wit, you: <br />I <br />This restriction of use is effective heginning on and shall remain in effect until 06ACAC <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 - you are entitled to an informal hearing to contest this Notice. A request 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 informal 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 maii exclude anjione, other than and those Aresentin t ' onj* from the inforinal hearin@. <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 />(S ignature of 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 />White Copy: Public Works Green Copy: File Yellow Copy: Report Copy Pink Copy: Recipient Gold Copy: Officer Appeal notice Rev. 04,103 <br />Name: Last Fi,,t Middle <br />DOB: <br />Races x: <br />P� <br />i <br />Res. Address: City <br />State <br />Zip <br />Res, Phone: <br />Work Phone: <br />9 t <br />L-1 <br />1 111 1 11111111111111111! Illp I I! I!Il III! I i Ili I I <br />The basis for this Notice of Restriction of Use is that on o <br />you violated Section — 1 , ( 90( o ' the Park <br />and Open Space Rules, arl Section _ "� of the Eugene Code, 1971 and/or ORS — 1 To wit, you: <br />I <br />This restriction of use is effective heginning on and shall remain in effect until 06ACAC <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 - you are entitled to an informal hearing to contest this Notice. A request 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 informal 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 maii exclude anjione, other than and those Aresentin t ' onj* from the inforinal hearin@. <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 />(S ignature of 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 />White Copy: Public Works Green Copy: File Yellow Copy: Report Copy Pink Copy: Recipient Gold Copy: Officer Appeal notice Rev. 04,103 <br />