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NOTICE OF RESTRICTION OFUSE <br />DATE: ~ t <br />and Notice of night to Appeal <br />,1'1,1: CASE <br />T � � �� %,� T, <br />Under the authority of Administrative Order No. 58-03- and Park and Open Space Rule ®10005(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 Facilities. <br />(Description of the violation.) <br />This restriction of use is effective beginning o n o , and shall remain in effect until <br />If you enter in or use any City of Eugene park, open suttee or facility daring the effective period of this Notice, your 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 liar are <br />informal Bearing must be m ade in writing and filed with the Parks & Open Space Division Director ("thy 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 informal hearing to be conducted, which shall he 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, ether than you and those presenting testimony, from the informal hearing. <br />rrhis Notice shall remain in effect pending any requested hearing <br />This Notice of Exclusion was delivered to the person named at the trap of this Notice at the date and time shown abov=e by: <br />(Signature of'person isstaira 'del v r ing notice) <br />I here by acknowledge receipt of the above. Notice can the elate and tinge indicated above. <br />(Signature of person being issued the notice) <br />`sadesrtc Copy 1'ublic Worb, Gac n Copy; Fttc Y,, How C'op y: rye poit t (:Ty [' nk Copy Rea;ipiew Uotd Copy, OfflQer Appc ak nartioc Re% 04/03 <br />Narne: st First addle <br />DOB7 <br />R ar e`Se . <br />Tr IN� <br />Res. Acldress City <br />State <br />dip <br />lies. Pbone: <br />Work Phone: <br />Under the authority of Administrative Order No. 58-03- and Park and Open Space Rule ®10005(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 Facilities. <br />(Description of the violation.) <br />This restriction of use is effective beginning o n o , and shall remain in effect until <br />If you enter in or use any City of Eugene park, open suttee or facility daring the effective period of this Notice, your 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 liar are <br />informal Bearing must be m ade in writing and filed with the Parks & Open Space Division Director ("thy 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 informal hearing to be conducted, which shall he 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, ether than you and those presenting testimony, from the informal hearing. <br />rrhis Notice shall remain in effect pending any requested hearing <br />This Notice of Exclusion was delivered to the person named at the trap of this Notice at the date and time shown abov=e by: <br />(Signature of'person isstaira 'del v r ing notice) <br />I here by acknowledge receipt of the above. Notice can the elate and tinge indicated above. <br />(Signature of person being issued the notice) <br />`sadesrtc Copy 1'ublic Worb, Gac n Copy; Fttc Y,, How C'op y: rye poit t (:Ty [' nk Copy Rea;ipiew Uotd Copy, OfflQer Appc ak nartioc Re% 04/03 <br />