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NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />DATE: TIME: -L3 I K CASE # <br />LOCATION (PARK/OPEN SPACE): <br />11� <br />A Entering in or using all City of Eugene parks, open spaces or facilities, <br />The basis for this Notice of Restriction of Use is that on you violated Section of the Park- <br />Open pace Rules, and/or Section of the Eugene Code, 197 1, and/or OR.S To wit, you: <br />/I <br />V (' -d�- <br />VCIL V P T7f A94 rbk5 5 1- / 14AI <br />(Description of the violation.) <br />This restriction of use is effective beginning on 02-2S and shall remain in effect until <br />3_ <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 />informal hearing must be made in writing and fi'ied with the Parks & Open Space Division Director ("the Division Director") <br />within 48 hours (exclusive of weekends� of recei2.t of this Notice at the followin address: 1820 Roosevelt, Blvd, <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 receipt of the request for hearing. At the informal hearing the Division Director will only <br />consider testimony from you, City person-net 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 pre cnttng timony, 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 Xerfi`ce at the date and time shown above by: <br />igna �urc of person issuing /delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and ti <br />neatest <br />(Signature of person being issued the notice) <br />While Copy: Public Works Green Copy: File Yellow Copy: Report Copy Pink Copy: Recipient Gold Copy: Officer Appeal notice Rm 04/03 <br />N ne: Last I st Mi die <br />DO B� <br />Race/Sex: <br />A 61 U <br />Res. Address Ci <br />Lflss <br />Stat e <br />6f— 1 <br />Zip <br />( 7740 <br />Res. Phone: <br />Work Phone: <br />A Entering in or using all City of Eugene parks, open spaces or facilities, <br />The basis for this Notice of Restriction of Use is that on you violated Section of the Park- <br />Open pace Rules, and/or Section of the Eugene Code, 197 1, and/or OR.S To wit, you: <br />/I <br />V (' -d�- <br />VCIL V P T7f A94 rbk5 5 1- / 14AI <br />(Description of the violation.) <br />This restriction of use is effective beginning on 02-2S and shall remain in effect until <br />3_ <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 />informal hearing must be made in writing and fi'ied with the Parks & Open Space Division Director ("the Division Director") <br />within 48 hours (exclusive of weekends� of recei2.t of this Notice at the followin address: 1820 Roosevelt, Blvd, <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 receipt of the request for hearing. At the informal hearing the Division Director will only <br />consider testimony from you, City person-net 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 pre cnttng timony, 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 Xerfi`ce at the date and time shown above by: <br />igna �urc of person issuing /delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and ti <br />neatest <br />(Signature of person being issued the notice) <br />While Copy: Public Works Green Copy: File Yellow Copy: Report Copy Pink Copy: Recipient Gold Copy: Officer Appeal notice Rm 04/03 <br />