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NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />DATE: TIME: CASE # <br />5L�5 1 N ?- 0 <br />/q <br />LOCATION (PAR.KJOPEN SPACE): EA, ST PA Z Y K <br />­­­--6-Luc — ------------------------- - - - <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 />El Entering in or using all City of Eugene parks, open spaces or facilities. <br />111 <br />ocv-s ea-r PAKY— g I ()CY-S <br />- --------------- - --------- - -------- - -------- - --------------- - I - ------- ­­- <br />The basis for this Notice of Restriction of Use is that on t you violated Section of the Park <br />and Open Space Rules, and/or Section of the Eugene Code, 1 971„ and/or ORS — -- - - - - -, To wit, you:_ <br />PD-S S FS S F j Q s - 1 4AN I DUNOF DF �\LA C 15UA NA = -UC- ()4r-)Z <br />Pursuairt to Park and Open Space Rule R- 1.074 you are entitled to air 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 Director") <br />within 48 hours (exclusive of weekends) of receipt of this N otice at the fri [lowing address: 1820 Roosevelt, Blvd., Eugene, 0 R <br />97402. <br />The Division Director shall schedule a time and place for the inforinal hearing to be conducted, which shall be not more than <br />72 hours (exclusive of weekends) of receipt of the request for hearing. At the informal hearing the Divi sion 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, 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 />0 —\ --- —1 H � --------------------- <br />(Signature of person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />E ller' t lie not ice) (Signiature Z pets n being issue notice) <br />VNIite 4 opy Pubfic Works Green copy: FOP Ydlow Copy: 3 eport Copy Pink Cupyi R�xrpicja GO J CcV y 1 0 Wi ver Appca I notice Rev, (W03 <br />Name: Last Middle <br />7Hom psoo f - p- C-DEOtK <br />I <br />"� I I <br />I <br />Ra", , scx - <br />W /NA <br />Re%, Address, <br />I H 51 WAII--fz 31 <br />te <br />?gyp <br />-T <br />Res. Phone: <br />Work Phone: <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 />El Entering in or using all City of Eugene parks, open spaces or facilities. <br />111 <br />ocv-s ea-r PAKY— g I ()CY-S <br />- --------------- - --------- - -------- - -------- - --------------- - I - ------- ­­- <br />The basis for this Notice of Restriction of Use is that on t you violated Section of the Park <br />and Open Space Rules, and/or Section of the Eugene Code, 1 971„ and/or ORS — -- - - - - -, To wit, you:_ <br />PD-S S FS S F j Q s - 1 4AN I DUNOF DF �\LA C 15UA NA = -UC- ()4r-)Z <br />Pursuairt to Park and Open Space Rule R- 1.074 you are entitled to air 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 Director") <br />within 48 hours (exclusive of weekends) of receipt of this N otice at the fri [lowing address: 1820 Roosevelt, Blvd., Eugene, 0 R <br />97402. <br />The Division Director shall schedule a time and place for the inforinal hearing to be conducted, which shall be not more than <br />72 hours (exclusive of weekends) of receipt of the request for hearing. At the informal hearing the Divi sion 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, 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 />0 —\ --- —1 H � --------------------- <br />(Signature of person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />E ller' t lie not ice) (Signiature Z pets n being issue notice) <br />VNIite 4 opy Pubfic Works Green copy: FOP Ydlow Copy: 3 eport Copy Pink Cupyi R�xrpicja GO J CcV y 1 0 Wi ver Appca I notice Rev, (W03 <br />