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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 />Entering in or using all City of Eugene parks, open spaces or facilities. <br />and 0 en Space Rules, andJor Section q - of the Eugene Code, 1971, and/or ORS To wit, you <br />5 <br />�P h �j � �L4 <br />tDescription Of the Vii)]WiOrl.) <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 (luring 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 />informal hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />within 48 hours (exclusive of weekends) of receipt of this Notice at the following address: 1820 Roosevelt, Blvd., Eugene, OR <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 infomial 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 tire person named at the top of this Notice at the date and time shown above by: <br />(Signature of person issuing/delivering notice) <br />I hereby acknowledge recerpt of the above Notice on the date and time indicated above. <br />,sign Fire cl p s I is. d tile notice) <br />Whhe Cop%s: Public Wark Green Copy: File Yellow Copy, Reportl Copy Fink Copy: RecipwnL Gold Copy: Officer Appeal notk. Ke , 04 1, <br />Name: Last First Middle <br />106: <br />Race Sex - <br />U <br />Res. Address: rY <br />State <br />zi <br />Req. Phoiie: <br />Work Phone: <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 />Entering in or using all City of Eugene parks, open spaces or facilities. <br />and 0 en Space Rules, andJor Section q - of the Eugene Code, 1971, and/or ORS To wit, you <br />5 <br />�P h �j � �L4 <br />tDescription Of the Vii)]WiOrl.) <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 (luring 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 />informal hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />within 48 hours (exclusive of weekends) of receipt of this Notice at the following address: 1820 Roosevelt, Blvd., Eugene, OR <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 infomial 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 tire person named at the top of this Notice at the date and time shown above by: <br />(Signature of person issuing/delivering notice) <br />I hereby acknowledge recerpt of the above Notice on the date and time indicated above. <br />,sign Fire cl p s I is. d tile notice) <br />Whhe Cop%s: Public Wark Green Copy: File Yellow Copy, Reportl Copy Fink Copy: RecipwnL Gold Copy: Officer Appeal notk. Ke , 04 1, <br />