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LOCATION (PARK/OPEN SPACE): CHA4NEL <br />Under the authority 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 />Entering in or using all City of Eugene parks, open spaces or faeflities� <br />The basis for this Notice of Restriction of Use is that on <br />Lj you violated Section f.0 IC4 of the Park <br />and Open Space Rules, and/or Section of the Eugene Code, 1971, andJor ORS To wit, you: <br />z <br />(,Description of the violation.) <br />This restriction of use is effective beginning on, 04 2ZZi4 and shall remain in effect until V1 24 '201 - <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 cniminal trespass in the second degree. <br />Pursuant to Park and Open Space Rule R- 1.074 you are entitled to an inforn 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, Blvd., Eugene, OR <br />97402. <br />The Division Director shall schedule a time and place for the inf'onnal hearing to be conducted, which shall be not more than <br />72 hours (exclusive ot'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 Division Director may exclade 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 Fxclusion was delivered to the person earned at the top of this Notice at the date and time shown above by: <br />(C�S ofperson is` ngidelivering 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 />Whilv Copy Public Woiks Cireen Copy, File Y elh Copy: Repon. C opy Fink Copy! Recipient Go ld C o1w: 0 ffig cer Appeal noti <br />Rear- 114 "03 <br />Name; fast First Middle <br />DOB: <br />Race /Sex: <br />-F <br />1OL-_ <br />Res. Address: city <br />.... . . . . . ... . <br />Res. Phone <br />........... .......... <br />Work Phone: <br />Fate <br />Under the authority 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 />Entering in or using all City of Eugene parks, open spaces or faeflities� <br />The basis for this Notice of Restriction of Use is that on <br />Lj you violated Section f.0 IC4 of the Park <br />and Open Space Rules, and/or Section of the Eugene Code, 1971, andJor ORS To wit, you: <br />z <br />(,Description of the violation.) <br />This restriction of use is effective beginning on, 04 2ZZi4 and shall remain in effect until V1 24 '201 - <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 cniminal trespass in the second degree. <br />Pursuant to Park and Open Space Rule R- 1.074 you are entitled to an inforn 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, Blvd., Eugene, OR <br />97402. <br />The Division Director shall schedule a time and place for the inf'onnal hearing to be conducted, which shall be not more than <br />72 hours (exclusive ot'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 Division Director may exclade 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 Fxclusion was delivered to the person earned at the top of this Notice at the date and time shown above by: <br />(C�S ofperson is` ngidelivering 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 />Whilv Copy Public Woiks Cireen Copy, File Y elh Copy: Repon. C opy Fink Copy! Recipient Go ld C o1w: 0 ffig cer Appeal noti <br />Rear- 114 "03 <br />