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NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />DATE: — a� – o �l � TIME; <br />CASE #: <br />LOCATION (PARK/OPEN SPACE): C a( - 0:)( v-� <br />Under the authoritv 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 />�6 Entering in or using all City of Eugene parks, open spaces or facilities. <br />F1 <br />Fhis restriction of use is effective beginning on and shall remain in effect until 14,1 <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 8 you are entitled to an informal hearing to contest this Notice. A request For all <br />infonnal 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 />7 2 hours (exclusive of weekends) of receipt ci the request for hearing. At the informal hearing the Division D irector will only <br />consider testimony from you, City personnel involved in the incident that resulted in this Noticc, and other Witnesses to the <br />incident, The Division Director may exclude anyone, other than you and those presenting testimony, front the lnibrnia-1 hearing, <br />This Notice shall remain in effect pending any requested hearing. <br />'This Notice o Exe lusion was delivered to the person named at the top o this Notice at the date and time shown above by: <br />'D ----------------- <br />o n i s �ssu i j delivering no <br />nn <br />(Signature of pen g/itice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />-_ - -- --- - ------ <br />(Signature of person being issued the notice) <br />Iffhac, Copy: Publik: Worh-s Gruco Ojpy; F& Ydki%y Copy: Ruport Copy Pink Copy. RctAplent Gold Copy, 00"icer Appeal notice Rev, OVO <br />Narne: La. Finst Middle <br />DOB <br />Race,Sex .. <br />Z <br />�T4 <br />. . ..... ........ ... <br />Rey - Addres.. : City <br />State <br />Zip <br />Res, Phone: <br />Work Phone: <br />Under the authoritv 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 />�6 Entering in or using all City of Eugene parks, open spaces or facilities. <br />F1 <br />Fhis restriction of use is effective beginning on and shall remain in effect until 14,1 <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 8 you are entitled to an informal hearing to contest this Notice. A request For all <br />infonnal 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 />7 2 hours (exclusive of weekends) of receipt ci the request for hearing. At the informal hearing the Division D irector will only <br />consider testimony from you, City personnel involved in the incident that resulted in this Noticc, and other Witnesses to the <br />incident, The Division Director may exclude anyone, other than you and those presenting testimony, front the lnibrnia-1 hearing, <br />This Notice shall remain in effect pending any requested hearing. <br />'This Notice o Exe lusion was delivered to the person named at the top o this Notice at the date and time shown above by: <br />'D ----------------- <br />o n i s �ssu i j delivering no <br />nn <br />(Signature of pen g/itice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />-_ - -- --- - ------ <br />(Signature of person being issued the notice) <br />Iffhac, Copy: Publik: Worh-s Gruco Ojpy; F& Ydki%y Copy: Ruport Copy Pink Copy. RctAplent Gold Copy, 00"icer Appeal notice Rev, OVO <br />