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NOTICE OF RESTRICTION OF USE
<br />and Notice of Right to Appeal
<br />�
<br />DATE. TIME CASE #:
<br />LOCATION (PARKIIOPFN SPACE):
<br />. ................................ . . . . . .
<br />tinder the authority ofAchninistrative Order No. 58-03-24-Fand Parkand Open Space Rule R-1.005(3), you are here
<br />notified that you are prohibited from (check box): I
<br />><— Entering in or using all City of Eugene parks, open spaces or facilities.
<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 L4 A of the Eugene Code, 1971, and/or ORS To wit, you,_
<br />_& �-" � 0 �ffiJ �(!, �OF A�tcokk - �L N�ij
<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- 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 (he 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 />974412.
<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 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 informal hearing.
<br />"Chis. Notice shall remain in effect pending any requested hearing.
<br />This Notice ol'Exclusion was delivered to the person named at the top orthis Notice, at the date and time shown above by:
<br />- -- - - - - ---------- - --------------
<br />(Signature ol'person issuing delivering nonce)
<br />I hereby acknowledge receipt ofthe above Notice on the date and time indicated above.
<br />Jo\j cj-sil, v
<br />(Signature of person being issued the notice)
<br />White <'opy: Public Works Green Copy: File Yellow Copy: Report Copy P Ink Copy Recipient G dd Copy; 0f ice r Appeal nL t i ce Rev, 04,01
<br />Name: Last t First Middle
<br />A�KXA
<br />DOB: g
<br />acetSex:
<br />_>Ley
<br />Res. Addre,": i
<br />-1-1-1 � )A i t C ly -
<br />jf hss
<br />State
<br />Zip
<br />Res. Phone,.:
<br />Work Phone:
<br />tinder the authority ofAchninistrative Order No. 58-03-24-Fand Parkand Open Space Rule R-1.005(3), you are here
<br />notified that you are prohibited from (check box): I
<br />><— Entering in or using all City of Eugene parks, open spaces or facilities.
<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 L4 A of the Eugene Code, 1971, and/or ORS To wit, you,_
<br />_& �-" � 0 �ffiJ �(!, �OF A�tcokk - �L N�ij
<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- 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 (he 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 />974412.
<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 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 informal hearing.
<br />"Chis. Notice shall remain in effect pending any requested hearing.
<br />This Notice ol'Exclusion was delivered to the person named at the top orthis Notice, at the date and time shown above by:
<br />- -- - - - - ---------- - --------------
<br />(Signature ol'person issuing delivering nonce)
<br />I hereby acknowledge receipt ofthe above Notice on the date and time indicated above.
<br />Jo\j cj-sil, v
<br />(Signature of person being issued the notice)
<br />White <'opy: Public Works Green Copy: File Yellow Copy: Report Copy P Ink Copy Recipient G dd Copy; 0f ice r Appeal nL t i ce Rev, 04,01
<br />
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