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NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />`�`�s� 2-5 1 1 C)j <br />DATE: 11-5 TIME: / CASE ##: <br />LOCATION (PARK/OPEN SPACE) Cc <br />4 -------- <br />notified that you are prohibi ed from (check box): <br />of Entering in or using all City of Eugene parks, open spaces or facilities. <br />F <br />The basis for this Notice of Restriction of Use is that on Os& you violated Section /(3 of the Park <br />and Open Space Rules, and/or Section , <br />2. 0 fq_ of the Eugene Code, 1971, andlor ORS -. To wit, you, <br />fl 2 <br />...................... <br />(Description of the violation.) I <br />This restriction of use is effective beginning on 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 />informal hearing must be rnade in writing and filed with the Parks & Open Space Division Director ("the Division Directoe') <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 may exclude anyone, other than you and those presenting testimonv, from the info al 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 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 Cheer Copy: File Yellow Copy: Report Copy Pink Copy: Recipient Gold Copy: Officer Appeal notice Rev. 04 03 <br />Name: Last First Middle <br />DOB: <br />Race/Se <br />z <br />Lo <br />w <br />4 <br />R Address: City <br />State <br />zip <br />R es. es. Phone: <br />Work Phone� <br />notified that you are prohibi ed from (check box): <br />of Entering in or using all City of Eugene parks, open spaces or facilities. <br />F <br />The basis for this Notice of Restriction of Use is that on Os& you violated Section /(3 of the Park <br />and Open Space Rules, and/or Section , <br />2. 0 fq_ of the Eugene Code, 1971, andlor ORS -. To wit, you, <br />fl 2 <br />...................... <br />(Description of the violation.) I <br />This restriction of use is effective beginning on 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 />informal hearing must be rnade in writing and filed with the Parks & Open Space Division Director ("the Division Directoe') <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 may exclude anyone, other than you and those presenting testimonv, from the info al 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 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 Cheer Copy: File Yellow Copy: Report Copy Pink Copy: Recipient Gold Copy: Officer Appeal notice Rev. 04 03 <br />