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Under the authority of Administrative Order No. 58-03-24-F and Park and Open Space Rule R-1.005( you are hereby <br />notified that you are prohibited from (check boxh: <br />Entering its or using all City of Eugene parks, open spaces or facilities. <br />X <br />The basis for this Notice of Restriction of Use is that on you violated Section w q6 the Park <br />and Open Space Rules, and/or Section of the Eugene Code, 1971, and/or ORS To wit, you: <br />(Description of the violation.) <br />This restriction of use is effective heginning on and shall remain in effect until <br />Il'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 second degree. <br />Pursuant to Park and Open Space Rule R -1 .074 you are entitled to an infiotnial hearing to contest this Notice. A request kir an <br />informal hearing must be made in writing and filed with the Parks & C - )pen Space Division Director ("the Division Director <br />within 49 hours (exclusive of weekends) of receipt of this Notice at the following address: 1820 Roosevelt, Blvd., Eugene, Oft <br />97402. <br />The Division Director shal schedule a time and pl ace for the i n 1 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 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 />I' o suing/ eliv <br />(Signature orpers, n isiering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above, <br />— ------- - - <br />- - - - -- - ----- -- --------------- <br />(SiguatUrc of person being issued the notice) <br />Whi e Copy, Public Works Grecn Copy� Filc Y d1ow Cqpy: Report Copy T ink t upy: Red i i p i t Lit Gold Copy! Officer Appeal notice Ric. 0410 <br />Name: Last First Middle <br />DOB: <br />Race/ e <br />'A <br />Res. 1 City <br />State <br />Res. Phone: <br />Work Phone: <br />�IocvN <br />Pj <br />Under the authority of Administrative Order No. 58-03-24-F and Park and Open Space Rule R-1.005( you are hereby <br />notified that you are prohibited from (check boxh: <br />Entering its or using all City of Eugene parks, open spaces or facilities. <br />X <br />The basis for this Notice of Restriction of Use is that on you violated Section w q6 the Park <br />and Open Space Rules, and/or Section of the Eugene Code, 1971, and/or ORS To wit, you: <br />(Description of the violation.) <br />This restriction of use is effective heginning on and shall remain in effect until <br />Il'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 second degree. <br />Pursuant to Park and Open Space Rule R -1 .074 you are entitled to an infiotnial hearing to contest this Notice. A request kir an <br />informal hearing must be made in writing and filed with the Parks & C - )pen Space Division Director ("the Division Director <br />within 49 hours (exclusive of weekends) of receipt of this Notice at the following address: 1820 Roosevelt, Blvd., Eugene, Oft <br />97402. <br />The Division Director shal schedule a time and pl ace for the i n 1 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 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 />I' o suing/ eliv <br />(Signature orpers, n isiering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above, <br />— ------- - - <br />- - - - -- - ----- -- --------------- <br />(SiguatUrc of person being issued the notice) <br />Whi e Copy, Public Works Grecn Copy� Filc Y d1ow Cqpy: Report Copy T ink t upy: Red i i p i t Lit Gold Copy! Officer Appeal notice Ric. 0410 <br />