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LOCATION (PARK/OPEN SPACE) SvjN,N6 <br />,, <br />Name: Last First Middle <br />DOB1 <br />Race/Sex: <br />z <br />LQ <br />Res. Address; City <br />State <br />Zip <br />lq'747S <br />Res. Phone: <br />Work Phone: <br />D ai <br />I <br />OAL <br />/Od Entering in or using all City of Eugene parks, open spaces or facilities. <br />Is <br />The basis for this Notice of Restriction of Use is that on you violated Section L H of the Park <br />(_�_ <br />and Open Space Rules, andlor Section _4]5 of the Eugene Code, 1971, and/or ORS . To wit, you: <br />(Description of the violation.) <br />This restriction of use is effective beginning on L)`d � , �- , and shall remain in effect until D4, H_2�L <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 info al 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 rslved in the incident that resulted in this Notice, and other witnesses to the <br />incident. The Division Director may exclude a,,, one, other than you and those presenting testin from the informal 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 />L <br />(Si of erson issuing/delivering notice) <br />