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NOTICE OF RESTRICTION OF USE
<br />and Notice of Right to Appeal
<br />DATE: _U
<br />'riw: CASE#:
<br />LOCNI'l'ON (PAR /OPEN SPACE):
<br />&LIJ
<br />Res, Addre Citv
<br />13)
<br />U nder 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 />N --" Entering in or using all City of Eugene parks, open spaces or facilities.
<br />N
<br />The basis; for this Notice of Restriction of Use is that on you violated Section of the Park
<br />and Open Space Rules, and/or Section ofthe Eugene Code, 171, and/or ORS �7
<br />-�, �-o. Y. wit Y ou:_
<br />ril
<br />(Description of the violation.)
<br />This restriction of use is effective beginning on jb__q 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 trCSPaSS in the second degree.
<br />Punsuant to Park and Open Space Rule R -1.074 you are entitled to an informal hearing to contest this Notice. A request f6r 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 follmving address: 1820 Roosevelt, Blvd, Eugene, OR
<br />97402.
<br />The Division Director shall schedule a firrie and place for the inferential hearing to be conducted, which shall be not more than
<br />72 hours (exclusive of weekends) ot'receipt of the request for hearing, At the informal 'hearing the Division Director will only
<br />consider testiniony from you, City personnel it 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 infoirna) 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 porson
<br />I hereby acknowledge receipt of the above Notice on the date and time indicated above.
<br />(Si gnature of person being issue( i notice)
<br />0,
<br />'
<br />White Copy: P1311fic ovi Circm CLpy� Fike Ydfovv Copy! Report Cg-aPy Pink Copy: Res ;pent Gold Copy Officer Appeitl antis Rev, W13
<br />Name� Last First Middle
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<br />Res, Addre Citv
<br />13)
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<br />es—phone:
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<br />Work Phone:
<br />U nder 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 />N --" Entering in or using all City of Eugene parks, open spaces or facilities.
<br />N
<br />The basis; for this Notice of Restriction of Use is that on you violated Section of the Park
<br />and Open Space Rules, and/or Section ofthe Eugene Code, 171, and/or ORS �7
<br />-�, �-o. Y. wit Y ou:_
<br />ril
<br />(Description of the violation.)
<br />This restriction of use is effective beginning on jb__q 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 trCSPaSS in the second degree.
<br />Punsuant to Park and Open Space Rule R -1.074 you are entitled to an informal hearing to contest this Notice. A request f6r 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 follmving address: 1820 Roosevelt, Blvd, Eugene, OR
<br />97402.
<br />The Division Director shall schedule a firrie and place for the inferential hearing to be conducted, which shall be not more than
<br />72 hours (exclusive of weekends) ot'receipt of the request for hearing, At the informal 'hearing the Division Director will only
<br />consider testiniony from you, City personnel it 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 infoirna) 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 porson
<br />I hereby acknowledge receipt of the above Notice on the date and time indicated above.
<br />(Si gnature of person being issue( i notice)
<br />0,
<br />'
<br />White Copy: P1311fic ovi Circm CLpy� Fike Ydfovv Copy! Report Cg-aPy Pink Copy: Res ;pent Gold Copy Officer Appeitl antis Rev, W13
<br />
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