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11 111 11 SPIN 111111 !11Iiiiiii!llli 111111!111 iIIIII! I! !'111 7 1 111 111 1 1 1 1, 111] 1 11 111 <br />�m Entering in or using all City of Eugene parks, open spaces or facilities. <br />El <br />(Description of the violation,) <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 R- 1.074 you are entitled to an informal hearing to contest this Notice. A request for an <br />info al hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />within 49 hours (exclusive ofweekends) of receipt of this Notice at the following address: 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />11C 1111U1111111 Heal jurg 0011(juclu LYU HUL MUTT= <br />7 rvision 1 Trector sna k a nine a <br />72 hours (exclusive of weekends) of receipt 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 />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 />(Signature of person issuing/delivering notice) <br />1 hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />(Signature of person being issued the notice) <br />White Copy: Public Works Green Copy: File Yellow Copy: Report Copy Pink Copy: Recipient Gold Copy: Officer Appeal nM ice Rev. 04.103 <br />Name: Last First Middle <br />DOB: <br />R ac e / ex: <br />�tl Xi - <br />I <br />U <br />u2 <br />P cs. s, city <br />State <br />Zip <br />Res. Phone: <br />Work Phone: <br />�dres <br />11 111 11 SPIN 111111 !11Iiiiiii!llli 111111!111 iIIIII! I! !'111 7 1 111 111 1 1 1 1, 111] 1 11 111 <br />�m Entering in or using all City of Eugene parks, open spaces or facilities. <br />El <br />(Description of the violation,) <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 R- 1.074 you are entitled to an informal hearing to contest this Notice. A request for an <br />info al hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />within 49 hours (exclusive ofweekends) of receipt of this Notice at the following address: 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />11C 1111U1111111 Heal jurg 0011(juclu LYU HUL MUTT= <br />7 rvision 1 Trector sna k a nine a <br />72 hours (exclusive of weekends) of receipt 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 />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 />(Signature of person issuing/delivering notice) <br />1 hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />(Signature of person being issued the notice) <br />White Copy: Public Works Green Copy: File Yellow Copy: Report Copy Pink Copy: Recipient Gold Copy: Officer Appeal nM ice Rev. 04.103 <br />