LOCATION (PARK/OPEN SPACE): <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 />Entering in or using all City of Eugene parks, open spaces or facilities. <br />(Description of the violation.) <br />This restriction of use is effective beginning on0_Mc9-/Y and shall remain in effect until. Oeiqrw�l—, <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 second degree. <br />Pursuant to Park and Open Space Rule R- 1.074 you are entitled to an informal hearing to contest this Notice. A request lorar <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., Eugene, 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 ot'weekends) of receipt orthe request for hearing. At the inforn'ral 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 oNhis. Notice at the date and tin wn a. ove by: <br />i gifyre o I'person I'SSL[i n g/oel i V eri ng 11 od cc I <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />(Signature of person being issued the notice) <br />WhAe Copy: public 6 ork-q Green Copy: File Yellow Copy! Report Cup Pin Copy ; kc6pien Gold Copy: Offlicer Appeed notice Rev, UV03 <br />Namc� Last i rst i ii d I e <br />B: <br />Race./sex , <br />7 <br />\ ft7�j F i f[7'J <br />Res. Address: City <br />State <br />State <br />Z' <br />Res, Plione- <br />Work Phcine. <br />t &I <br />lei <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 />Entering in or using all City of Eugene parks, open spaces or facilities. <br />(Description of the violation.) <br />This restriction of use is effective beginning on0_Mc9-/Y and shall remain in effect until. Oeiqrw�l—, <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 second degree. <br />Pursuant to Park and Open Space Rule R- 1.074 you are entitled to an informal hearing to contest this Notice. A request lorar <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., Eugene, 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 ot'weekends) of receipt orthe request for hearing. At the inforn'ral 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 oNhis. Notice at the date and tin wn a. ove by: <br />i gifyre o I'person I'SSL[i n g/oel i V eri ng 11 od cc I <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />(Signature of person being issued the notice) <br />WhAe Copy: public 6 ork-q Green Copy: File Yellow Copy! Report Cup Pin Copy ; kc6pien Gold Copy: Offlicer Appeed notice Rev, UV03 <br />