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LOCATION (PARK/OPEN SPACE): F-j��j ItWA-ft XK,
<br />Under the authority of Administrative Order No. 58-03-24-F and Park and Open Space Rule R"1.0,105(3 you are hereby
<br />witifled that you are prohibited from (check box):
<br />�D Entering in or using all City of Eugene parks, open spaces or facilities.
<br />0
<br />The basis for this Notice of Restriction of Use is that on 1_ALJ _, you violated Section) 01 60q of the Park
<br />and Open Space Rules, andlor Section --- of the Eugene Code, 1971, andior OR.Sq I 5 -%Cq . To wit, you. L-Ckc'
<br />t if12 f' i o ta.
<br />,F
<br />(Description of the violation.)
<br />This restriction of use is effective beginning o w ,
<br />and shall remain in effect until
<br />—Pt—
<br />If you enter in or use any City of Eugene park, open space or facility during the effect] ve Period of this N otice, 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 itil'ormal hearing to contest this Notice. A request fur an
<br />infortrial hearing must be matte 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 />72 - hours (exclusive of weekends) of receipt of the request for hearing. At the informal hearing the Division Drrec7tor will on
<br />consider testimony from you, City personnel involved in the incident that resulted in this Notice, and other witnesses to t
<br />le '
<br />incident. The Division Director may exclude anyone, other than you and those presenting teqtimony, from the informal 1hearin
<br />This Notice shall remain in effect pending any requestLd hearing.
<br />This Notice of Exclusion was delivered to the person named at the top of this Notice at the dale and time shown above by
<br />(Signature of person isiuing/defivering notice)
<br />I hereby acknowledge receipt of the above Notice on the date and time indicated above,
<br />P - ----- - - - - --
<br />-- -
<br />--�tk-r �N,ja�-N
<br />(Signature of person being issued the notice)
<br />white Copy: Ptshfic Woric, Green Copy! File Yellow Copy! Report Copy Pink Copy: Recipient G old Copy: Officer App� a I notive Rev- 04,103
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<br />Name: Last First Middle
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<br />Res. city
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<br />Zip
<br />Reg- Phone.
<br />Work Phone:
<br />Under the authority of Administrative Order No. 58-03-24-F and Park and Open Space Rule R"1.0,105(3 you are hereby
<br />witifled that you are prohibited from (check box):
<br />�D Entering in or using all City of Eugene parks, open spaces or facilities.
<br />0
<br />The basis for this Notice of Restriction of Use is that on 1_ALJ _, you violated Section) 01 60q of the Park
<br />and Open Space Rules, andlor Section --- of the Eugene Code, 1971, andior OR.Sq I 5 -%Cq . To wit, you. L-Ckc'
<br />t if12 f' i o ta.
<br />,F
<br />(Description of the violation.)
<br />This restriction of use is effective beginning o w ,
<br />and shall remain in effect until
<br />—Pt—
<br />If you enter in or use any City of Eugene park, open space or facility during the effect] ve Period of this N otice, 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 itil'ormal hearing to contest this Notice. A request fur an
<br />infortrial hearing must be matte 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 />72 - hours (exclusive of weekends) of receipt of the request for hearing. At the informal hearing the Division Drrec7tor will on
<br />consider testimony from you, City personnel involved in the incident that resulted in this Notice, and other witnesses to t
<br />le '
<br />incident. The Division Director may exclude anyone, other than you and those presenting teqtimony, from the informal 1hearin
<br />This Notice shall remain in effect pending any requestLd hearing.
<br />This Notice of Exclusion was delivered to the person named at the top of this Notice at the dale and time shown above by
<br />(Signature of person isiuing/defivering notice)
<br />I hereby acknowledge receipt of the above Notice on the date and time indicated above,
<br />P - ----- - - - - --
<br />-- -
<br />--�tk-r �N,ja�-N
<br />(Signature of person being issued the notice)
<br />white Copy: Ptshfic Woric, Green Copy! File Yellow Copy! Report Copy Pink Copy: Recipient G old Copy: Officer App� a I notive Rev- 04,103
<br />1
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