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M <br />Underthe authority of: dminnistrative 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 />"X— Entering in or using all City of Eugene parks, open spaces or facilities. <br />0 - <br />TTk��p 1 N7,o A- 0--r7 <br />(Description of the violation.) Ari 6-N-C C- L1161 D <br />This restriction of use is effective beginning onO6 2-11 acrd shall remain in effect until <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 see and degree. <br />Pursuant to Park an Open Space Rule R- 1.0174 you are entitled to an info n 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 atthe following address. 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />The Division Director shall schedule a time and place for the Mi'ort hearing to be conducted, which shall be not more than <br />7- hours (exclusive of'weekendq) of receipt of the request for hearing. At the informal hearing the Division Directm will only <br />consider testimony fi 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, from 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 time shown above by: <br />(Signature of person issuing/delivering notice) <br />I hereby acknowledge receipt oFthc above Notice on the date and tinic indicated above. <br />K 11, <br />(Signature of person being issued the notreeg <br />Wh i e Copy: Pu b h c Wo rks (ircen Copy Nk�, Yelklw Copy_ ReporT Copy Pink Copy: Rvc ipi4zn& Gold Copy: Olooer Appeal wAwe Pcv, 04M3 <br />N�a�tast First <br />DOB <br />R, <br />Res. Address, or C i tv <br />f <br />state <br />Zip <br />Res. Phone: <br />Worl< Phone: <br />PIC, <br />M <br />Underthe authority of: dminnistrative 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 />"X— Entering in or using all City of Eugene parks, open spaces or facilities. <br />0 - <br />TTk��p 1 N7,o A- 0--r7 <br />(Description of the violation.) Ari 6-N-C C- L1161 D <br />This restriction of use is effective beginning onO6 2-11 acrd shall remain in effect until <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 see and degree. <br />Pursuant to Park an Open Space Rule R- 1.0174 you are entitled to an info n 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 atthe following address. 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />The Division Director shall schedule a time and place for the Mi'ort hearing to be conducted, which shall be not more than <br />7- hours (exclusive of'weekendq) of receipt of the request for hearing. At the informal hearing the Division Directm will only <br />consider testimony fi 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, from 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 time shown above by: <br />(Signature of person issuing/delivering notice) <br />I hereby acknowledge receipt oFthc above Notice on the date and tinic indicated above. <br />K 11, <br />(Signature of person being issued the notreeg <br />Wh i e Copy: Pu b h c Wo rks (ircen Copy Nk�, Yelklw Copy_ ReporT Copy Pink Copy: Rvc ipi4zn& Gold Copy: Olooer Appeal wAwe Pcv, 04M3 <br />