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Under f 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 facilitie& <br />X <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 - of the Eugene Code, 1971, and/or ORS To writ, you: <br />(Description of the violation.) <br />This restriction of use is effective beginning on l , and shall remain its effect until t <br />If you enter in or use any City. of Eugene park- open space or facility daring the effective period of this Notice, you may be <br />arrested and charged with criminal trespass in the second degree, <br />Pursuant to Dark and Open Space Rule k-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 ol`weekends) ofreceipt of this Notice at the following address: 1820 Roosevelt, Blvd., Eugene, O <br />974 02. <br />The Division Director shall schedule a time and place for the infor hearing to be conducted, which shall be not more than <br />72 hours (exclusive ol`weekends) of receipt of the request for hearing. At the informal hearing the Division Director will only <br />consider testimony From you, City perso - nnel involved in the incident that resulted in this Notice, and other witnesses to the <br />incident. The Division Director may exclude anyone, rather 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 the person named at the top of this Notice at the date and time shown above y: <br />(tiign,attrr��V son issuing/delivering notice) ._ <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />(Signature of perso being issued the notice) <br />White, Copy Public works t reen Cotay: Fide YeAlm dopy: ('eprsrt CGPY P1tik Copy! Rr tcipteni GAd Copy; 0fri ".g..Ap1m I notai4 kr4, O=4 03 <br />Name: Last First Middle <br />DOB: <br />Race`Serc_ <br />s <br />M 03 /97 <br />Ties. Address: City <br />State_ <br />Zip <br />fees. Phone: <br />Work Phone.: <br />Under f 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 facilitie& <br />X <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 - of the Eugene Code, 1971, and/or ORS To writ, you: <br />(Description of the violation.) <br />This restriction of use is effective beginning on l , and shall remain its effect until t <br />If you enter in or use any City. of Eugene park- open space or facility daring the effective period of this Notice, you may be <br />arrested and charged with criminal trespass in the second degree, <br />Pursuant to Dark and Open Space Rule k-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 ol`weekends) ofreceipt of this Notice at the following address: 1820 Roosevelt, Blvd., Eugene, O <br />974 02. <br />The Division Director shall schedule a time and place for the infor hearing to be conducted, which shall be not more than <br />72 hours (exclusive ol`weekends) of receipt of the request for hearing. At the informal hearing the Division Director will only <br />consider testimony From you, City perso - nnel involved in the incident that resulted in this Notice, and other witnesses to the <br />incident. The Division Director may exclude anyone, rather 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 the person named at the top of this Notice at the date and time shown above y: <br />(tiign,attrr��V son issuing/delivering notice) ._ <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />(Signature of perso being issued the notice) <br />White, Copy Public works t reen Cotay: Fide YeAlm dopy: ('eprsrt CGPY P1tik Copy! Rr tcipteni GAd Copy; 0fri ".g..Ap1m I notai4 kr4, O=4 03 <br />