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NOTICE OF RESTRICTION OF USE <br />t)ti 1i 541-15 <br />DATE: (, ( A 1\ L�--- <br />TIME: <br />j 0 — CASE <br />[ ---- i ----------------------- A <br />LOCATION (PAR /OPEN SPACE): <br />�1 Ali L <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 />notifled that you are prohihited from (check box): <br />9!51 Entering in or using all pity of Eugene parks, open spaces or facilities. <br />The basis for this Notice of Restriction of Use is that on o GO A you violated Section )qf ,he Park <br />and Open Space Rules, andJor Section of the Eugene Code, 1971, and/or OR To wit, you <br />N <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. Areq nest for an <br />informal hearing trust be, made in writing and Filed with the Parks & Open Space Division Director ("the Division Direr toe') <br />within 48 hours (exclusive of weekends) of receipt of this Notice at the following address: 1920 Roosevelt, Blvd., Eugene, OR <br />97402. <br />The Division Director cihall 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, firorn 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 by: <br />TJ � -- - - --------------- <br />(Signature of person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the (late and time indicated above, <br />(Signature of person being issued the notice) <br />Wha�� CiTy: Publiv WurkN GrccnCkTy, File Yelh m- • Copy! ReN ri Copy Pink copy kucipicn Gold Ci py. 0 f wcer Appca I nutice 04,03 <br />Name: ast First Middle <br />DOB: <br />Race/sex <br />�1 Ali L <br />Res, Address: City <br />State <br />dip <br />Res. Phone: <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 />notifled that you are prohihited from (check box): <br />9!51 Entering in or using all pity of Eugene parks, open spaces or facilities. <br />The basis for this Notice of Restriction of Use is that on o GO A you violated Section )qf ,he Park <br />and Open Space Rules, andJor Section of the Eugene Code, 1971, and/or OR To wit, you <br />N <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. Areq nest for an <br />informal hearing trust be, made in writing and Filed with the Parks & Open Space Division Director ("the Division Direr toe') <br />within 48 hours (exclusive of weekends) of receipt of this Notice at the following address: 1920 Roosevelt, Blvd., Eugene, OR <br />97402. <br />The Division Director cihall 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, firorn 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 by: <br />TJ � -- - - --------------- <br />(Signature of person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the (late and time indicated above, <br />(Signature of person being issued the notice) <br />Wha�� CiTy: Publiv WurkN GrccnCkTy, File Yelh m- • Copy! ReN ri Copy Pink copy kucipicn Gold Ci py. 0 f wcer Appca I nutice 04,03 <br />