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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 her by <br />notified that you are prohibited from (check. box) <br />- SP Entering in or using all City of Eugene parks, open spaces or facilities. <br />The basis for this Notice of Restriction of Use is that on G you violated Section <br />f the Park.. <br />and Open Space Rules, an&or Section ci r the F ugene Code, 1971, andlor ORS T43 wit, you <br />0 Q�) r- (\V11 0 0 6- <br />( Description o C the viol ati on .) <br />This restriction of use is effective beginning on -I I � - <br />-0 �kl and shall remain in effect until I 0 <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 It - you are entitled to an informal hearing to contest this Notice. A request for an <br />informal hearing most be made in writing and filed with the Parks & Open Space Division Director ("the Division Director <br />within 48 hour's (exclusive of weekends) of receipt ofthis Notice at the following iddress: 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />The Divi sion D irector shal I sc hedule a time and place for the infonnal hearing to be conducted, which shal I be not more than <br />72 hours (exclusive of weekends) of receipt of the request for hearing, At the infomial hearing the Division Director wi H 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 Divisdon Director may exclude anyone, other than you and those presenting testimony, firom 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 data and time shown above by; <br />::4 Jo <br />�,T� --------------------------- -- <br />(Signature o C person i 98L[Ing/del i Verillg n0ti CC) <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 />Wlwe Copy: Public Works Green Copy: File Yellow Copy: Repon, C opy Pink Copy: Recipient Gold Copy: Officor Appeal nutic Re OVOI <br />Nanic. I asL <br />Finq Middle <br />DOB <br />Raccis <br />U4 <br />Res. A ress: <br />City <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 her by <br />notified that you are prohibited from (check. box) <br />- SP Entering in or using all City of Eugene parks, open spaces or facilities. <br />The basis for this Notice of Restriction of Use is that on G you violated Section <br />f the Park.. <br />and Open Space Rules, an&or Section ci r the F ugene Code, 1971, andlor ORS T43 wit, you <br />0 Q�) r- (\V11 0 0 6- <br />( Description o C the viol ati on .) <br />This restriction of use is effective beginning on -I I � - <br />-0 �kl and shall remain in effect until I 0 <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 It - you are entitled to an informal hearing to contest this Notice. A request for an <br />informal hearing most be made in writing and filed with the Parks & Open Space Division Director ("the Division Director <br />within 48 hour's (exclusive of weekends) of receipt ofthis Notice at the following iddress: 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />The Divi sion D irector shal I sc hedule a time and place for the infonnal hearing to be conducted, which shal I be not more than <br />72 hours (exclusive of weekends) of receipt of the request for hearing, At the infomial hearing the Division Director wi H 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 Divisdon Director may exclude anyone, other than you and those presenting testimony, firom 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 data and time shown above by; <br />::4 Jo <br />�,T� --------------------------- -- <br />(Signature o C person i 98L[Ing/del i Verillg n0ti CC) <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 />Wlwe Copy: Public Works Green Copy: File Yellow Copy: Repon, C opy Pink Copy: Recipient Gold Copy: Officor Appeal nutic Re OVOI <br />