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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 />notified that you are prohibited from (check box): <br />Entering in or using all City of Eugene pen parks, o spaces or facilities. <br />,X 1 1 , <br />W <br />The basis for this Notice of Restriction of Use is that on you violated Section <br />OP 4 --1 )of the Park <br />and Open Space Rules, andJor Section L I )JO (if the Eugene Code, 1971, and/or ORS To wit, you.: <br />Pj- 7A- -1 -1 ftrz I? <br />(Description of the violation,) <br />This restriction of use is effective beginning on P ernain in. eff <br />I I andshall r -ect until <br />f - F <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 forarl <br />info sal hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />within 49 hours (exclusive of'weekends) of receipt of this - Notice at the following address: 1920 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 hour; (CXCIUSiVC ol'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 Divisiou Director may exclude anyone, other than you and those presenting testimony, from the informal hearing. <br />This Notice shall remain in effect pending any requested bearing. <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 />(Signature of person issu-inp/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />(Signature of person being issued the notice) <br />White Cupyi Public WorL GnenCupyi FbIu Yellow Copy; IUpurt Copy Pink Copy. Recipien Ciold Copy: of Appeit notice Rev, 04/01 <br />Nanic: Last First Middle <br />DOB: <br />Race/scx: <br />- A -7 it <br />jaq <br />24 <br />Res, Address: City <br />Stale <br />p <br />Res' <br />Wt,)rk Phone� <br />1 <br />/ C <br />I <br />- <br />1W ,' Y - j <br />( h J-(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 />notified that you are prohibited from (check box): <br />Entering in or using all City of Eugene pen parks, o spaces or facilities. <br />,X 1 1 , <br />W <br />The basis for this Notice of Restriction of Use is that on you violated Section <br />OP 4 --1 )of the Park <br />and Open Space Rules, andJor Section L I )JO (if the Eugene Code, 1971, and/or ORS To wit, you.: <br />Pj- 7A- -1 -1 ftrz I? <br />(Description of the violation,) <br />This restriction of use is effective beginning on P ernain in. eff <br />I I andshall r -ect until <br />f - F <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 forarl <br />info sal hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />within 49 hours (exclusive of'weekends) of receipt of this - Notice at the following address: 1920 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 hour; (CXCIUSiVC ol'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 Divisiou Director may exclude anyone, other than you and those presenting testimony, from the informal hearing. <br />This Notice shall remain in effect pending any requested bearing. <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 />(Signature of person issu-inp/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />(Signature of person being issued the notice) <br />White Cupyi Public WorL GnenCupyi FbIu Yellow Copy; IUpurt Copy Pink Copy. Recipien Ciold Copy: of Appeit notice Rev, 04/01 <br />