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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): Ob C, i?tq 2- s- 6 ��- <br />0 <br />The basis for this Notice of Restriction of Use is that on you violated Section L?1-17TCO of the Park <br />and Open Space Rules, and/or Section -- of the Eugene Code, 1971, and/or ORS —. 'ro wit, you: <br />:7AI /A f2 I x <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- you are entitled to an infon 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 (eXCIUSiVe of weekends) ofreceipt ofthis Notice at the following address 1820 Roosevelt, Blvd., Eugene, OR <br />97402® <br />The D ivision D irector shal 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 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 infortnal hearing. <br />This Notice shall remain in effect pending any requested hearing. <br />This Notice of Exclusion was delivered to the person trained at the top of this Notice a e date and t shon above bye <br />tz 1'r- / I- <br />..... .. - - - -- <br />(Signature of person issuing/delivering noticc) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />0 ' NJ (AJA C-RA- <br />(Signature of person being issued the notice) <br />White Copy: Public Works 4 reen Copy: File 3 dlow Copy; Report Copy Pink Copy: Excipicic Gokl Copy: Offixr Appei� natiQe Rev, 04413 <br />Narne: Last First Middle <br />D()B: <br />Race/Sex: <br />12�2- `:o <br />Res. Address: C fly <br />S t <br />T Zip <br />Res. Phone, <br />Work Phone: <br />CIP <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): Ob C, i?tq 2- s- 6 ��- <br />0 <br />The basis for this Notice of Restriction of Use is that on you violated Section L?1-17TCO of the Park <br />and Open Space Rules, and/or Section -- of the Eugene Code, 1971, and/or ORS —. 'ro wit, you: <br />:7AI /A f2 I x <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- you are entitled to an infon 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 (eXCIUSiVe of weekends) ofreceipt ofthis Notice at the following address 1820 Roosevelt, Blvd., Eugene, OR <br />97402® <br />The D ivision D irector shal 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 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 infortnal hearing. <br />This Notice shall remain in effect pending any requested hearing. <br />This Notice of Exclusion was delivered to the person trained at the top of this Notice a e date and t shon above bye <br />tz 1'r- / I- <br />..... .. - - - -- <br />(Signature of person issuing/delivering noticc) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />0 ' NJ (AJA C-RA- <br />(Signature of person being issued the notice) <br />White Copy: Public Works 4 reen Copy: File 3 dlow Copy; Report Copy Pink Copy: Excipicic Gokl Copy: Offixr Appei� natiQe Rev, 04413 <br />