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tinder the authority of Adm in istrative Order No. 58-03-24-F and Parka nd Open Space Rule R-1,065(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 />EJ <br />Pursuant to Park and Open Space Rule R-1.074 you are entitled to an informal hearing to contao this Notice, A request bran <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., En gene, OR <br />97402. <br />The Division Director shall schedule a time and place for the informal 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 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, 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 />- 01� -------- -------------- <br />(Signature o f" person i ssu ing/delivering notice) <br />Names Last First Middle <br />fFMC <br />D - B <br />Racc,'Scx°- <br />�V A6 <br />Res. Address: <br />stale <br />Zip <br />Res, Ninne <br />Work Phone: <br />tinder the authority of Adm in istrative Order No. 58-03-24-F and Parka nd Open Space Rule R-1,065(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 />EJ <br />Pursuant to Park and Open Space Rule R-1.074 you are entitled to an informal hearing to contao this Notice, A request bran <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., En gene, OR <br />97402. <br />The Division Director shall schedule a time and place for the informal 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 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, 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 />- 01� -------- -------------- <br />(Signature o f" person i ssu ing/delivering notice) <br />