NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />DATE: -61-WAI TIME: 'S / 51_V�N CASE # <br />LOCATIONWARK/OPENSRACE)� -G- fl-Ak <br />f - ---- - - - ------------------- <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 />15V- Entering in ar u%ing all City of Eugene parks, open spaces or facilities. <br />X1 <br />The basis for this Notice of Restriction of Use is that on you violated Section 19�ilnl& (lie Park <br />and Open Space Rules, and/or Section HJ y) of the Eugene Code, 1971, ancl/or ORS To wit, you: _jLJCkZC <br />4-sx sz) k) 0 1P P e,�j , � 0 3 �? 2)) 11 A� C E <br />{ Description of the violation.) <br />&-� <br />This restriction use is of ective beginning on rind sh all r 4 <br />em ain in effect until c <br />of <br />21 <br />tf 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 air(! charged with criminal trespass in the second degree. <br />Pursuant to Park and Open Space Rule R -1 .074 you are entitled to an in Car nnal 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 shal sched ul c a time and place for the in formal hearing to be conducted, which shal be not more than <br />72 hours (exclusive of weekends) of receipt of the request for hearing. At the informal hearing the Division Director wi 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, other than you and those presenting testimony, rrom the informal 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 bane shown above by: <br />(Signature of person issuing/delivering not'see) <br />I hereby acknowlcdge receipt of the above Notice on the date and time indicated above. <br />(Signature of pper.,lonking ISSLIed the notico) <br />White Copye Public Works Green Copy: File Yellow Copy Rcport Copy Pink Copy; Rmipien,( (30d Copy Offijw�r Appe--d notice Rev- W V,, <br />Manic: Last First Middle <br />D013- <br />Racell"Sex: <br />rA WY <br />C Id-c <br />tn <br />Address: ty <br />Res.: - JS <br />State <br />Zip <br />Res, Phone: <br />Work Phone: <br />e: <br />_[ <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 />15V- Entering in ar u%ing all City of Eugene parks, open spaces or facilities. <br />X1 <br />The basis for this Notice of Restriction of Use is that on you violated Section 19�ilnl& (lie Park <br />and Open Space Rules, and/or Section HJ y) of the Eugene Code, 1971, ancl/or ORS To wit, you: _jLJCkZC <br />4-sx sz) k) 0 1P P e,�j , � 0 3 �? 2)) 11 A� C E <br />{ Description of the violation.) <br />&-� <br />This restriction use is of ective beginning on rind sh all r 4 <br />em ain in effect until c <br />of <br />21 <br />tf 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 air(! charged with criminal trespass in the second degree. <br />Pursuant to Park and Open Space Rule R -1 .074 you are entitled to an in Car nnal 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 shal sched ul c a time and place for the in formal hearing to be conducted, which shal be not more than <br />72 hours (exclusive of weekends) of receipt of the request for hearing. At the informal hearing the Division Director wi 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, other than you and those presenting testimony, rrom the informal 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 bane shown above by: <br />(Signature of person issuing/delivering not'see) <br />I hereby acknowlcdge receipt of the above Notice on the date and time indicated above. <br />(Signature of pper.,lonking ISSLIed the notico) <br />White Copye Public Works Green Copy: File Yellow Copy Rcport Copy Pink Copy; Rmipien,( (30d Copy Offijw�r Appe--d notice Rev- W V,, <br />