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NOTICE OF RESTRICTION OF USE <br />DATE. <br />and Notice of Right to Appeal <br />TIME: CASE <br />LOCATION PARKJOPFN SPACE): <br />,j A6 h - 9*J( j N Aj <br />JUTT-Y <br />notified that you are prohibited from (check box). <br />Entering in or using all City of Eugene parks, open spaces or facilities. <br />011 <br />(Description or the violation.) <br />f <br />This restriction d shall remain in effect until <br />on o use is effective beginning on _060 <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 ft- 1.074 you are entitled to an informal hearing to contest this Notice. A request for an <br />info al hearing musa 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 hollowing 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're-ceipt of the request for hearing. At the info gal hearing the Division- Director will only <br />consider testimony from you, City jim, onnel 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 testimony, from the informal hearing. <br />This Notice shall remain in effect pending any requested hearing, <br />This Notice of Exclusion wag delivered to the person named at the top of this Notice at the date and time snown above by: <br />(Signature of rzer", )i issuin otico) <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 />Alite Copy: Public, WtAss � re�n Copy: File Y u I h,) w Copy - 1 kxpurt Copy Pink Copy: Rccipient Gold Copy� 0 ffi cer Appua I nc�t ice Rev 04M3 <br />Name: Last H"I Middle <br />DOB� <br />Ra C C/S e.X, <br />G <br />Res Addr- City <br />State <br />Zip <br />Res. Phone: <br />Work Phone: <br />JUTT-Y <br />notified that you are prohibited from (check box). <br />Entering in or using all City of Eugene parks, open spaces or facilities. <br />011 <br />(Description or the violation.) <br />f <br />This restriction d shall remain in effect until <br />on o use is effective beginning on _060 <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 ft- 1.074 you are entitled to an informal hearing to contest this Notice. A request for an <br />info al hearing musa 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 hollowing 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're-ceipt of the request for hearing. At the info gal hearing the Division- Director will only <br />consider testimony from you, City jim, onnel 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 testimony, from the informal hearing. <br />This Notice shall remain in effect pending any requested hearing, <br />This Notice of Exclusion wag delivered to the person named at the top of this Notice at the date and time snown above by: <br />(Signature of rzer", )i issuin otico) <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 />Alite Copy: Public, WtAss � re�n Copy: File Y u I h,) w Copy - 1 kxpurt Copy Pink Copy: Rccipient Gold Copy� 0 ffi cer Appua I nc�t ice Rev 04M3 <br />