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LOCATION WARKJOPEN SPACE): M�*4t&%r <br />h Qu -1 Al <br />Under the authority of Administrative Order No. 58-03-24-F and Park and Open Space Rule R-1.005( you are hereby <br />notified that you are prohibited from (check box): <br />V <br />Xw, Entering in or using all City of Eugene parks, open spaces or facilities. <br />* <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 />Purquarn to Park and Open Space Rule R- I e 074 you are entitled to an informal. hearin 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 49 hours (exclusive of week ends) of receipt of this N otice at the following address 1820 Roosevelt, Blvd., Eugen e., OR <br />97402. <br />The Division Director shall schedule a time and place for the infarinal 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 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 Divi%ion Director may exclude anyone, other than you and those presenting testimony, from the info rnialhearing, <br />This Notice shall rem-tin 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 tune shown above by: <br />defivei <br />(Signature of person " suing/defivoring 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 Copy! Publ ic Wo rk, 4 Green Copy: File Yellow Copy. Report Copy Pink Copy Recipiew 6dd Copy Officer AppA notice R4,v . 044163 <br />Nacre: Last First Middle <br />DOB: <br />Race/Sex: <br />RAI <j 441.4 C� J <br />Res. Address: City State <br />Zip <br />acs. Phone: <br />W ork P hone� <br />Under the authority of Administrative Order No. 58-03-24-F and Park and Open Space Rule R-1.005( you are hereby <br />notified that you are prohibited from (check box): <br />V <br />Xw, Entering in or using all City of Eugene parks, open spaces or facilities. <br />* <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 />Purquarn to Park and Open Space Rule R- I e 074 you are entitled to an informal. hearin 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 49 hours (exclusive of week ends) of receipt of this N otice at the following address 1820 Roosevelt, Blvd., Eugen e., OR <br />97402. <br />The Division Director shall schedule a time and place for the infarinal 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 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 Divi%ion Director may exclude anyone, other than you and those presenting testimony, from the info rnialhearing, <br />This Notice shall rem-tin 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 tune shown above by: <br />defivei <br />(Signature of person " suing/defivoring 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 Copy! Publ ic Wo rk, 4 Green Copy: File Yellow Copy. Report Copy Pink Copy Recipiew 6dd Copy Officer AppA notice R4,v . 044163 <br />