NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />TIME: <br />LOCATION (PARKjOPEN SPACE): <br />7 <br />Name: Last First Middle <br />ee <br />DOB: <br />Ra e <br />M kJ VA&,W <br />Res, Address: city <br />Sta <br />Lip <br />Res, Phone <br />Work P <br />(Description of the violation� <br />at <br />- Ikj W —) <br />IT-! -<_, <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 -1.074 you are entitled to an informal hearing to contest this Notice. Arequest fiver 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 weekendq) orreecipt ofthis 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 inure than <br />72 hours (exclusive of weekends) of receipt of the req nest for hearing. At the informal hearing the Division Director will rare <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 testimony, from the informal hearing. <br />This Notice shall rernain in effect pending any requested hearing, <br />This Notice of Exclusit)n was delivered to the person named at the top of this Notice at the date and time shown above by: <br />----------- . .................. . ........... <br />(Signa e" <br />ture of issuing/defivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />. .. . ...-- <br />(Si nature of person being issued the notice) <br />Whau, Copy: Public Work g, Green Copy: File Yellow Copy Repom Copy Pink Copy Recipimit Gold Copy: Officer Appeal notice Rev, 04,T� <br />