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N <br />DATE. TIME: CASE #, <br />LOCATION (PARK)OPEN SPACE): <br />_Cm' —(�- <br />and Open Space Rules, and/or Section L f k i 6 1 D of the Eugene Code, 1971„ and/or ORS I-------------,---, To wit, you -- <br />(Description of the violation.) <br />ThLs restriction of use is effective beginning onol -1 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 R-1.074 you are entitled to an inforTnal 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 />1L�rqjj*A44X C I as i v 0 0 f W of receiXt of t re mest for hearinv. At the jnfloiTmnal hearinop. the Division Director will on- <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 hearin <br />This Notice shall remain in effect pending any requested hearing. �i <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 />. .. ... I F <br />i�H "n <br />(Signature ofperson issuing/delivering 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 />While CtTy. PubVic WoKkq Green copy, He Y61aw Copy Rpart Copy Pink Copy. Recipient Guld Copy, Officer Appeai nonce Rev. 04M3 <br />Name: Last First Middle <br />DOB: <br />R,ace,`Scx <br />Res ddress: C-1ty <br />State <br />Z' <br />Res. Phwie; <br />Work Phone: <br />t alc <br />and Open Space Rules, and/or Section L f k i 6 1 D of the Eugene Code, 1971„ and/or ORS I-------------,---, To wit, you -- <br />(Description of the violation.) <br />ThLs restriction of use is effective beginning onol -1 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 R-1.074 you are entitled to an inforTnal 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 />1L�rqjj*A44X C I as i v 0 0 f W of receiXt of t re mest for hearinv. At the jnfloiTmnal hearinop. the Division Director will on- <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 hearin <br />This Notice shall remain in effect pending any requested hearing. �i <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 />. .. ... I F <br />i�H "n <br />(Signature ofperson issuing/delivering 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 />While CtTy. PubVic WoKkq Green copy, He Y61aw Copy Rpart Copy Pink Copy. Recipient Guld Copy, Officer Appeai nonce Rev. 04M3 <br />