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Under the authority of Administrative Order No. 58-03-24-F and Park and Open Space Rule R-1.005(3), you are hereby <br />notified that you are prohibited from (check box')-. <br />)5� 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 <br />_9AN� of the Park <br />and Open Space Rules, and/or Section _, of the Eugene Code, 1971, and/or ORS _ To wit, you <br />(Description of the violation.) <br />This restriction of use is effective beginning on VWXJ_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 - you are entitled to an in formal hearing to contest this Notice A request for ate <br />informal hearing niust be made in writing and filed with the Parks & Open Space Division Director ("the Division Director <br />within 48 hours (exclusive of weekends) ofreceipt of this Notice at the following address: 1920 Roosevelt, Blvd., Eugene, OR <br />97402. <br />The Division Director shall schedule a time and place for the infra Taal hearing to be coj)ducted, which shall be not more than <br />72 hours (exclusive of weekends) of receipt of the request for hearing. At the infornial, hearing the Division Director will only <br />consider testimony from you, City personnel involved in the incident that resulted in this Notice, Lind other witnesses to the <br />incident. The Division Director may exclude anyone, other than you and those presenting testimony, from the infort hearing. <br />This Notice shall remain in effect pending any requested hearing. <br />This Notice cat" Exclusion was delivered to the person named at the top of this Notice at the date and time shown above by: <br />(SignatUrC of person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />6 e <br />(Signature of person being issued the notieL°) <br />wMte Copy fluhhc Works oree➢ Copy FAA y6h)w Cojly. Rep Copy Pink Copy; Recipient GdW CopT OMer Appeal notice km 04,03 <br />Nauie: Last First Middle <br />D013: <br />taeei, _X� <br />f <br />YA 2 4 L <br />Res- Address: C ity <br />State <br />Zip <br />Re, Phone: <br />Work Phone: <br />C 1 `7 <br />Under the authority of Administrative Order No. 58-03-24-F and Park and Open Space Rule R-1.005(3), you are hereby <br />notified that you are prohibited from (check box')-. <br />)5� 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 <br />_9AN� of the Park <br />and Open Space Rules, and/or Section _, of the Eugene Code, 1971, and/or ORS _ To wit, you <br />(Description of the violation.) <br />This restriction of use is effective beginning on VWXJ_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 - you are entitled to an in formal hearing to contest this Notice A request for ate <br />informal hearing niust be made in writing and filed with the Parks & Open Space Division Director ("the Division Director <br />within 48 hours (exclusive of weekends) ofreceipt of this Notice at the following address: 1920 Roosevelt, Blvd., Eugene, OR <br />97402. <br />The Division Director shall schedule a time and place for the infra Taal hearing to be coj)ducted, which shall be not more than <br />72 hours (exclusive of weekends) of receipt of the request for hearing. At the infornial, hearing the Division Director will only <br />consider testimony from you, City personnel involved in the incident that resulted in this Notice, Lind other witnesses to the <br />incident. The Division Director may exclude anyone, other than you and those presenting testimony, from the infort hearing. <br />This Notice shall remain in effect pending any requested hearing. <br />This Notice cat" Exclusion was delivered to the person named at the top of this Notice at the date and time shown above by: <br />(SignatUrC of person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />6 e <br />(Signature of person being issued the notieL°) <br />wMte Copy fluhhc Works oree➢ Copy FAA y6h)w Cojly. Rep Copy Pink Copy; Recipient GdW CopT OMer Appeal notice km 04,03 <br />