q <br />L <br />NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />)q3 DATE. TIME: CASE #: <br />LOCATION (PARK/OPEN SPACE): <br />M <br />El <br />The basis for this Notice of Restriction of Use is that o you violated Section 11_01�4he Park <br />and Open Space Rules, and/or Section of the Eugene Code, 1971, and/or ORS To wit, you:_ <br />rz/Z q� <br />Wescription of the violation.) <br />0 <br />This restriction of use is effective beginning on <br />�, and %hall remain in effect until <br />If you enter in or use any City of Eugene park, open space or facility during the effective period oft is Notice, you may be <br />arrested and charged with criminal trespass in the sceond degree. <br />Pursuant to Park and Open Space Rule R -1.074 you are entitled to an informal hearing to contest this Notice. A request ffir an <br />informal hearing must be made in writing and filed with the Parks & Open Space Division Director ("the, Division Director <br />within 49 hours (,exclusive of weekends) of receipt of this Notice at the following address: 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />7. nours kexciu wueKcnus) of 1CCV1PL M UIC I M�MM-hil rcurMT- lv�jou Hu L <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 />This Notice of Exclusion was delivered to the • person named at the top of this Notic_e,-,ft the date and time shown above by. <br />(Sig6att r_e - of person issuing/delivering noticc) <br />I hereby acknowledge receipt of the above Notice on the date and time it <br />White Copy: Public Works Green cnpy: File V e HOW Copy: R upuyt Copy Pink Cupy! R uopicn r Ciold Copy: Offreer A ppcal noiivc Rev- 04163 <br />ame: Last IF in, t Middle <br />dt <br />DOB� <br />Races <br />Res. Addrcs%: city <br />State <br />Zip <br />Res. Phone: <br />Work Phone7 <br />- T ­ <br />El <br />The basis for this Notice of Restriction of Use is that o you violated Section 11_01�4he Park <br />and Open Space Rules, and/or Section of the Eugene Code, 1971, and/or ORS To wit, you:_ <br />rz/Z q� <br />Wescription of the violation.) <br />0 <br />This restriction of use is effective beginning on <br />�, and %hall remain in effect until <br />If you enter in or use any City of Eugene park, open space or facility during the effective period oft is Notice, you may be <br />arrested and charged with criminal trespass in the sceond degree. <br />Pursuant to Park and Open Space Rule R -1.074 you are entitled to an informal hearing to contest this Notice. A request ffir an <br />informal hearing must be made in writing and filed with the Parks & Open Space Division Director ("the, Division Director <br />within 49 hours (,exclusive of weekends) of receipt of this Notice at the following address: 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />7. nours kexciu wueKcnus) of 1CCV1PL M UIC I M�MM-hil rcurMT- lv�jou Hu L <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 />This Notice of Exclusion was delivered to the • person named at the top of this Notic_e,-,ft the date and time shown above by. <br />(Sig6att r_e - of person issuing/delivering noticc) <br />I hereby acknowledge receipt of the above Notice on the date and time it <br />White Copy: Public Works Green cnpy: File V e HOW Copy: R upuyt Copy Pink Cupy! R uopicn r Ciold Copy: Offreer A ppcal noiivc Rev- 04163 <br />