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NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />DATE: TIME: CASE # <br />-r / <br />LOCATION (PARK /OPEN SPACE): L%�A I A)(M A) PA P- L <br />Entering in or using all City of Eugene parks, open spaces or facilities. <br />05- 1 �Ik 31, j 1 <br />The basis for this Notice of Restriction of Use is th at on Q —, you violated Section OSO of the Park <br />and Open Space Rules, and/or Section t of the Eugene Code, 1971, and/or ORS To wit, you: <br />UQ A- CA QL F <br />6-1 - <br />This restriction of use is effective beginning on 0*4.1 ih/ IS7 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 inforinal 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: 1020 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 rcceipt of the request for hearing. At the informal hearing the Division Director will only <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 remain in effect pending any requested hearing. <br />White Copy: Public Works Green Copy: File Yellow Copy: Repon Copy Pink Copy: Recipient <br />�Signature ol'person being issued the notice) <br />Goid Cojry; Officer Appea I notice <br />Rev. 04�103 <br />Name 1, st First Middle <br />DOB! <br />lo - 7- Iq <br />Race/Sex <br />.. . . . .... . . ...... <br />r Lw <br />Res. Address-, City <br />State <br />Zip <br />Res. Phorie: <br />Work Plione: <br />Entering in or using all City of Eugene parks, open spaces or facilities. <br />05- 1 �Ik 31, j 1 <br />The basis for this Notice of Restriction of Use is th at on Q —, you violated Section OSO of the Park <br />and Open Space Rules, and/or Section t of the Eugene Code, 1971, and/or ORS To wit, you: <br />UQ A- CA QL F <br />6-1 - <br />This restriction of use is effective beginning on 0*4.1 ih/ IS7 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 inforinal 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: 1020 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 rcceipt of the request for hearing. At the informal hearing the Division Director will only <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 remain in effect pending any requested hearing. <br />White Copy: Public Works Green Copy: File Yellow Copy: Repon Copy Pink Copy: Recipient <br />�Signature ol'person being issued the notice) <br />Goid Cojry; Officer Appea I notice <br />Rev. 04�103 <br />