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NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />C i <br />��5 St�Le�'_ <br />DATE: TIME: PM CASE #: <br />LOCATION (PARK/OPEN SPACE):_, >-UL <br />_-P�A— I — -------- - - <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 />j If <br />iot ied that you are prohibited frorn (check box l: <br />Entering in or using all City of Eugene parks, open spaces or facilities. <br />The basis flor this Notice of Restriction of Use is that on Z9 q you violated Sectlon444 �wthc Park <br />V 0---- q-75&A <br />and Open Space Rules, and/or Section - of the Eugene Code, 1971, andlor ORS , . ....... . ... . ro wit, you:_ <br />Pursuant to Park and Open Space Rule R -1.074 you are entitled to an infornial 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 (exelusive of weekends) of receipt of the request for hearing. At the in rornial hearing the D ivision Director wil o nly <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 inforttial 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 />31 <br />(Signature of person issuing./deliverintz notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />(Signalffe of'person being issued the notice) <br />Wh i ic Copy; Pub! k `arks Green Copy: File Yvllow Copy: Report. Copy Pink Copy: Rvvipient Gold Copy; Officer Appeal notice Rc 0441 <br />Narne: Last <br />First <br />is <br />Middle <br />D <br />oz <br />Race/ Sex: <br />W <br />Res, Address: <br />city <br />State <br />Zip <br />Res. Phoney <br />Wor f 11 ne <br />ST4 ON - 7 <br />(HDA415 L 59) <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 />j If <br />iot ied that you are prohibited frorn (check box l: <br />Entering in or using all City of Eugene parks, open spaces or facilities. <br />The basis flor this Notice of Restriction of Use is that on Z9 q you violated Sectlon444 �wthc Park <br />V 0---- q-75&A <br />and Open Space Rules, and/or Section - of the Eugene Code, 1971, andlor ORS , . ....... . ... . ro wit, you:_ <br />Pursuant to Park and Open Space Rule R -1.074 you are entitled to an infornial 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 (exelusive of weekends) of receipt of the request for hearing. At the in rornial hearing the D ivision Director wil o nly <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 inforttial 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 />31 <br />(Signature of person issuing./deliverintz notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />(Signalffe of'person being issued the notice) <br />Wh i ic Copy; Pub! k `arks Green Copy: File Yvllow Copy: Report. Copy Pink Copy: Rvvipient Gold Copy; Officer Appeal notice Rc 0441 <br />