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LOCATION (PARK/OPEN SPACE):__L_N�Ci�M
<br />ILL(ClAM
<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 />k , 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 D( 2 1 ; 7,D1 you violated Section 0 of the Park
<br />and Open Space Rules, and/or Section of the Eugene Code, 1971, and/or ORS To wit, you:
<br />M
<br />(Description of the violation,)
<br />This restriction of use is effective beginning on D� 42_ , and shall remain in effect until OV 14 2 0 1
<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-1.074 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 Directoe')
<br />within 48 hours (exclusive of weekends) of receipt of this Notice at the following address 1820 Roosevelt, Blvd., Eugene, OR
<br />97401
<br />The Division Director shall schedule at time and place for the informal hearing to he conducted, which shall be not more than
<br />72 hours (exclusive of weekends) of receipt oCthe 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 tta 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 per%on named at the top of this Notice at the dente and time shown above by:
<br />- ---------------------
<br />(Signature of person i.suing/delivering notice)
<br />I hereby acknowledge receipt of the above Notice on the date and fitne indicated above.
<br />M
<br />(Signature o person being i ssued the notice)
<br />White Copy. Public Wcwks Green Copy: File Yellow Copy! Reim t Copy Pink Cnpy:, Rcopieni Guld Copy Offiker Appeal notice Rev, (A/03
<br />Name: Last First Middle
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<br />Race/ e X,
<br />MAir A�FVi At MNLeL
<br />_/Z 2D
<br />Res, Addrem. City
<br />Zip
<br />Res- Phone
<br />work phone
<br />LL
<br />7AA&8 i ENT
<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 />k , 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 D( 2 1 ; 7,D1 you violated Section 0 of the Park
<br />and Open Space Rules, and/or Section of the Eugene Code, 1971, and/or ORS To wit, you:
<br />M
<br />(Description of the violation,)
<br />This restriction of use is effective beginning on D� 42_ , and shall remain in effect until OV 14 2 0 1
<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-1.074 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 Directoe')
<br />within 48 hours (exclusive of weekends) of receipt of this Notice at the following address 1820 Roosevelt, Blvd., Eugene, OR
<br />97401
<br />The Division Director shall schedule at time and place for the informal hearing to he conducted, which shall be not more than
<br />72 hours (exclusive of weekends) of receipt oCthe 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 tta 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 per%on named at the top of this Notice at the dente and time shown above by:
<br />- ---------------------
<br />(Signature of person i.suing/delivering notice)
<br />I hereby acknowledge receipt of the above Notice on the date and fitne indicated above.
<br />M
<br />(Signature o person being i ssued the notice)
<br />White Copy. Public Wcwks Green Copy: File Yellow Copy! Reim t Copy Pink Cnpy:, Rcopieni Guld Copy Offiker Appeal notice Rev, (A/03
<br />
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