LOCATION (PARKJOPEN SPACE): <br />A& 1 i L "i D WA&XirJa1 S <br />Under the authoritv of Administrative Order No. 58-03-24-F and Park and Open Si pace Rule R- 1.005{3), you are herehy <br />notified that you are prohibited from (check box): <br />Entering in or using all City of Eugene parks, open spaces or Facilities. <br />The basis for this Notice of Restriction of Use is that on C>Y?�l you violated Section he Park <br />and Open Space Rules, and/or Section __ of the Eugene Code, 1971, an dJor ORS To wit, you, <br />U iiie kc <br />Descriptimi of the violation.) <br />L-f 4:z— <br />This restriction of use is effective beginning on 016 I—S/ q 1 , and 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 cif this Notice, you may be <br />arrested and charged with cTirninal trespass in the second degree. <br />Pursuant to Park and Open Space Rule R- 1.074 you are entitled to an Informal bearing to contest this Notice, A request for an <br />infonnal hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Directoe") <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 as 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 D ivision D irector may exclude anyone, other than you and those presenting testimony, from the in l'onnal 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 />4 <br />(Signature of person issuing/defivering noij <br />ce , <br />I hereby acknowledge receipt orthe above Notice on the date and time indicated above, <br />(Signature of person being issued the notice) <br />Wine Copy; Public, Works, Griccin Copy File Yellow Copy: Repod Copy Pink Copy Recipient Gild Copy: Offiliver Appeal notice Rcv. 04,03 <br />Pq Last First Middle <br />Qw W — 7AZeLzt- <br />DOB� <br />Race/sOX <br />j <br />J <br />des. J1 d r e s s city State <br />Zip <br />Res, Phone: <br />Work Phone: <br />r..,j ..... .... .. <br />Under the authoritv of Administrative Order No. 58-03-24-F and Park and Open Si pace Rule R- 1.005{3), you are herehy <br />notified that you are prohibited from (check box): <br />Entering in or using all City of Eugene parks, open spaces or Facilities. <br />The basis for this Notice of Restriction of Use is that on C>Y?�l you violated Section he Park <br />and Open Space Rules, and/or Section __ of the Eugene Code, 1971, an dJor ORS To wit, you, <br />U iiie kc <br />Descriptimi of the violation.) <br />L-f 4:z— <br />This restriction of use is effective beginning on 016 I—S/ q 1 , and 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 cif this Notice, you may be <br />arrested and charged with cTirninal trespass in the second degree. <br />Pursuant to Park and Open Space Rule R- 1.074 you are entitled to an Informal bearing to contest this Notice, A request for an <br />infonnal hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Directoe") <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 as 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 D ivision D irector may exclude anyone, other than you and those presenting testimony, from the in l'onnal 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 />4 <br />(Signature of person issuing/defivering noij <br />ce , <br />I hereby acknowledge receipt orthe above Notice on the date and time indicated above, <br />(Signature of person being issued the notice) <br />Wine Copy; Public, Works, Griccin Copy File Yellow Copy: Repod Copy Pink Copy Recipient Gild Copy: Offiliver Appeal notice Rcv. 04,03 <br />