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C. <br />Under the authority of Administrative Order � o.58-03-24 arrd Park and Open Space Rule R-1.005(3), you are hereby <br />notified that you are prohibited from (check box): <br />110 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 on and shall remain in effect until ca�c <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 />PUFSUant 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 />infortrial 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 tirric and place for the int'Ormal hearing to be conducted, which shall be not more than <br />71 hours (exclusive of weekends) of receipt of the request for hearing, At the infest al hearing the Division Director wi I I 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 D irector may exclude anyone, other than you and those presenting testirnouy, from the informa 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 />(Signature of person issrfinjl,(h lotice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />- - — — - . — ---------- <br />(Siglna�lturc ref being issued the notice) <br />While Cupyi Public Works Greet Copy: File Yellcn% Copy: Repurt Copy Pink Copy! Recipient Gold Copyi Officer Appeal notice Rcv, 041'01 <br />Name: Last First Middle <br />DOB: <br />Race/Sex: <br />. 4 <br />Res. Nddr- S— city <br />�- t <br />State <br />Zip <br />Res- Phone: <br />Work Phone: <br />cf, fiJ <br />C. <br />Under the authority of Administrative Order � o.58-03-24 arrd Park and Open Space Rule R-1.005(3), you are hereby <br />notified that you are prohibited from (check box): <br />110 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 on and shall remain in effect until ca�c <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 />PUFSUant 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 />infortrial 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 tirric and place for the int'Ormal hearing to be conducted, which shall be not more than <br />71 hours (exclusive of weekends) of receipt of the request for hearing, At the infest al hearing the Division Director wi I I 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 D irector may exclude anyone, other than you and those presenting testirnouy, from the informa 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 />(Signature of person issrfinjl,(h lotice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />- - — — - . — ---------- <br />(Siglna�lturc ref being issued the notice) <br />While Cupyi Public Works Greet Copy: File Yellcn% Copy: Repurt Copy Pink Copy! Recipient Gold Copyi Officer Appeal notice Rcv, 041'01 <br />