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Under the authority of Administrative Order No. and and Open Space ituie A-1.005(3), yuu are hereby <br />notified that you are prohibited from (check box): <br />R K Entering in or using all City of Eugene parks, open spaces or facilities. <br />Fe <br />The basis for this Notice of Restriction of Use is that on — 1 you violated Section a 3VO [I'Ll f the Park <br />and Open Space Rules, and/or Section of the Eugene Code, 1971 and/or O R S To wit. <br />you: <br />A Pit ML L 4 <br />(Description of the violation.) <br />This restriction of use is effective beginning on and shall remain in effect until <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 - you are entitled to an informal hearing to contest this Notice. A request for an <br />informal 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, 131vd., 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 hours (exclusive of weekends) of receipt of the request for hearing. At the info al 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, from 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 />...7 <br />(Signature of person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />t4,VA-r3LX . <br />(Signature of person being issued the notice) <br />White Copy: Public Works Green Copy He Yellow Copy: Report Copy Pink Copy: Recipient Gold Copy. Offi cer Appeal notice Rev, 04,'03 <br />Nanie: Last First Middle <br />DOB: <br />Race/sex: <br />z <br />Res. Address: city <br />State <br />Zip <br />Res, Phone: <br />Work Phone: <br />. / <br />— , AKSW�77-- <br />Under the authority of Administrative Order No. and and Open Space ituie A-1.005(3), yuu are hereby <br />notified that you are prohibited from (check box): <br />R K Entering in or using all City of Eugene parks, open spaces or facilities. <br />Fe <br />The basis for this Notice of Restriction of Use is that on — 1 you violated Section a 3VO [I'Ll f the Park <br />and Open Space Rules, and/or Section of the Eugene Code, 1971 and/or O R S To wit. <br />you: <br />A Pit ML L 4 <br />(Description of the violation.) <br />This restriction of use is effective beginning on and shall remain in effect until <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 - you are entitled to an informal hearing to contest this Notice. A request for an <br />informal 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, 131vd., 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 hours (exclusive of weekends) of receipt of the request for hearing. At the info al 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, from 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 />...7 <br />(Signature of person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />t4,VA-r3LX . <br />(Signature of person being issued the notice) <br />White Copy: Public Works Green Copy He Yellow Copy: Report Copy Pink Copy: Recipient Gold Copy. Offi cer Appeal notice Rev, 04,'03 <br />