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notified that you are prohibited from (check box): <br />Entering 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 . &V11 (6) of the Park <br />5---, you violated Section <br />and Open Space Rules, and/or Section 'Yfu" of the Eugene Code, 1971, and/or C IS - 1 To wit, you <br />-t-6x(- Iw-m-m-L- pz�:�j -,.*c AW4 q &X=—R1 i q ro&h Q�Amr -- <br />(Description of the violation.) <br />This restriction of use is effective beginning on 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 E -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 ("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 />r <br />Mm to t <br />consider testimony from you, City personnel involved in the incident that resulted in this Notice, and other witnesses to t <br />incident, The Division Director may exclude anyone, other than you and those presenting testimony, from the informal jh�earin <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 issuingidelivering 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 CreenCopy: He Yellow copy. Report Copy Pink Copy Recipient Gold Copy: Officer Appeal notice Rev. (W03 <br />Name: Last First Middle <br />DOB: <br />Rac&S <br />' 4 <br />4-j A ' C ' s <br />Res. Address: City <br />State <br />Zip <br />Res, Phone: <br />Work Phone: <br />notified that you are prohibited from (check box): <br />Entering 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 . &V11 (6) of the Park <br />5---, you violated Section <br />and Open Space Rules, and/or Section 'Yfu" of the Eugene Code, 1971, and/or C IS - 1 To wit, you <br />-t-6x(- Iw-m-m-L- pz�:�j -,.*c AW4 q &X=—R1 i q ro&h Q�Amr -- <br />(Description of the violation.) <br />This restriction of use is effective beginning on 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 E -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 ("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 />r <br />Mm to t <br />consider testimony from you, City personnel involved in the incident that resulted in this Notice, and other witnesses to t <br />incident, The Division Director may exclude anyone, other than you and those presenting testimony, from the informal jh�earin <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 issuingidelivering 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 CreenCopy: He Yellow copy. Report Copy Pink Copy Recipient Gold Copy: Officer Appeal notice Rev. (W03 <br />