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NOTICE OF RESTRICTION OF USE <br />DATE: AnV3-- <br />and Notice of Right to Appeal <br />TIME: <br />#-. -/0 <br />pleyA.- <br />6 l 6r <br />(Description of the violation.) <br />This restriction of use is effective beginning on and shall remain in effect until 0 YIS16- <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 />informal hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />within 48 kours �exclusive of weekends) of receiUt of this Notice at the following address� 1820 Roosevelt, Blvd., Eugene, OR <br />This Notice of Exclusion was delivered to the person named at the top of this Noti ate and time shown above by <br />c �7 � Tq <br />I hereby acknowledge receipt of the above Notice on the date and time indicated <br />crson issuing/delivering notice) <br />of person being issued the notice) <br />White Copy: Public Works Gteen Copy: File Yellow Copyl kcpoyt Copy Pink Copy: Recipient Cold Copy; Officer Appeal nolice <br />Rev. 04/03 <br />Narnes Last First Middle <br />DOB <br />Race/Sex; <br />z <br />Res. Address: City <br />State <br />i Z' <br />zd?, <br />Res. Phone: <br />Work Phone: <br />6 l 6r <br />(Description of the violation.) <br />This restriction of use is effective beginning on and shall remain in effect until 0 YIS16- <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 />informal hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />within 48 kours �exclusive of weekends) of receiUt of this Notice at the following address� 1820 Roosevelt, Blvd., Eugene, OR <br />This Notice of Exclusion was delivered to the person named at the top of this Noti ate and time shown above by <br />c �7 � Tq <br />I hereby acknowledge receipt of the above Notice on the date and time indicated <br />crson issuing/delivering notice) <br />of person being issued the notice) <br />White Copy: Public Works Gteen Copy: File Yellow Copyl kcpoyt Copy Pink Copy: Recipient Cold Copy; Officer Appeal nolice <br />Rev. 04/03 <br />