4.2.14b Park Restrictions - Laserfiche WebLink

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DATE: NOTICE OF RESTRICE, and Notice of �Right to Appe I LOCATION (PARK/OPEN SPACE): TIME: 14—ov— CASE #: �f - 0 Under the authority of Administrative Order No. 58-03-24-F and Park and Open Space Rule R-1.005(3), you are hereby notified that you are prohibited from (check box): >!f Entering in or using all City of Eugene parks, open spaces or facilities. L1 The basis for this Notice of Restriction of lJse is that on Q you violated Section L001Y)f the Park and Open Space Rules, and/or Section of the Eugene Code, 1971, and/or ORS To wit, you: - Z Dp E6__U N 7YJ71 N (Description of the violatiom) This restriction of w& is effective heginnino an A 4Z)r91 4 1 ® and shall remain In effect until 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 arrested and charged with criminal trespass in the second degree. Pursuant to Park and Open Space Rule R-1.074 you are entitled to an informal hearing to contest this Notice. Arequest for err infornial hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Director") within 48 hour% (exclusive of week-ends) of receipt of this Notice at the following address: 1820 Roosevelt, Blvd., Eugene, OR 97402. The Division Director shall schedule a time and place for the informal hearing to be conducted, which shall be not more than 72 hours ( ' exclusive of weekends) of receipt of the request for bearing. At the informal hearing the Division Director will only consider testimony from you, City personnel involved in the incident that resulted in this Notice, and other witnesses to the incident. The Division Director may exclude anyone, other than you and those presenting testimony, from the infornial hearing, This Notice shall remain in effkt pending any requested hearing, This Notice of Exclusion was delivered to the person named at the top of this Notice at the date and time s1:7b e by: ----------- (Signature of per issuing/delivering notice) I hereby acknowledge receipt of the above Notice on the date and time indicated above. (Signature of person being issued the notice) White Copy: Public. Works Gmen Copy: File Yeltow Copy: Report ( Pink Copy Recipient iUuld Cupy� Officu Appeal notice Rev, 04,'03 Nan . La19 , first Middle DOB: Race U L- , 's P SE P f �s- Address City State zip Res, Phone� Work Phone Under the authority of Administrative Order No. 58-03-24-F and Park and Open Space Rule R-1.005(3), you are hereby notified that you are prohibited from (check box): >!f Entering in or using all City of Eugene parks, open spaces or facilities. L1 The basis for this Notice of Restriction of lJse is that on Q you violated Section L001Y)f the Park and Open Space Rules, and/or Section of the Eugene Code, 1971, and/or ORS To wit, you: - Z Dp E6__U N 7YJ71 N (Description of the violatiom) This restriction of w& is effective heginnino an A 4Z)r91 4 1 ® and shall remain In effect until 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 arrested and charged with criminal trespass in the second degree. Pursuant to Park and Open Space Rule R-1.074 you are entitled to an informal hearing to contest this Notice. Arequest for err infornial hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Director") within 48 hour% (exclusive of week-ends) of receipt of this Notice at the following address: 1820 Roosevelt, Blvd., Eugene, OR 97402. The Division Director shall schedule a time and place for the informal hearing to be conducted, which shall be not more than 72 hours ( ' exclusive of weekends) of receipt of the request for bearing. At the informal hearing the Division Director will only consider testimony from you, City personnel involved in the incident that resulted in this Notice, and other witnesses to the incident. The Division Director may exclude anyone, other than you and those presenting testimony, from the infornial hearing, This Notice shall remain in effkt pending any requested hearing, This Notice of Exclusion was delivered to the person named at the top of this Notice at the date and time s1:7b e by: ----------- (Signature of per issuing/delivering notice) I hereby acknowledge receipt of the above Notice on the date and time indicated above. (Signature of person being issued the notice) White Copy: Public. Works Gmen Copy: File Yeltow Copy: Report ( Pink Copy Recipient iUuld Cupy� Officu Appeal notice Rev, 04,'03