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LOCATION (PARK/OPEN SPACE) �J+iJ346� <br />Under the authority of. d inistrat ve Order No. 58-03-24-F and Park and Open Space Rule R-1.005(3), you are herehy <br />natified that you are prohibited from (check box): <br />Entering in or using all City of Eugene parks, open spaces or facilities. <br />L1 <br />and Open Space Rules, and/or Section of the Eugene Code, 1971, and/or ORS qls� S(A . TO wit, you <br />- VotV4 6tLE 07-- MA <br />(Description of the violation.) <br />This restriction of use is effective beginning on 6 t 1 q , and shall rerna in in effect until V6 0 - 2 ' 4 <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- I , 074 you are entitl to an informal hearing to contest this N otice. A request for an <br />inibnnal 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 oft is Notice at the foltowing address: 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />The Division Director shalt schedule a time and place for the in ilormal hearing to be conducted, which shat( be not more than <br />72 hours (exclusive of weekends) of receipt of the request for hearing. At the informal hearing the Division Director wili 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 hearin <br />This Notice shall remain in effect pending any requested hearing. <br />Th is Notice of Exclusion was delivered to the person named at the top of this Notice at the date and time shown above 'by: <br />AA <br />T7 <br />(Signature of person issuing/delivering notice) <br />I here-by acknowledge receipt of the above Notice on the date �and time indicated above. <br />(Signature of person being issued the notiec) <br />White Copy Public Works Breen Copy: Fite YeRow Copyc RepoO Copy Pink C'opv: Recipient Gold Copy: Officer Appeil nofice Rev, 1A03 <br />Narne: Last First Middle <br />DOB <br />Race/Scx: <br />z <br />L& <br />Ic Ir kLk i Pq Tl � AJ M (c !Ai <br />Res. Address: City <br />State <br />L ip <br />Res. Phone: <br />Work Phone: <br />l: <br />Under the authority of. d inistrat ve Order No. 58-03-24-F and Park and Open Space Rule R-1.005(3), you are herehy <br />natified that you are prohibited from (check box): <br />Entering in or using all City of Eugene parks, open spaces or facilities. <br />L1 <br />and Open Space Rules, and/or Section of the Eugene Code, 1971, and/or ORS qls� S(A . TO wit, you <br />- VotV4 6tLE 07-- MA <br />(Description of the violation.) <br />This restriction of use is effective beginning on 6 t 1 q , and shall rerna in in effect until V6 0 - 2 ' 4 <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- I , 074 you are entitl to an informal hearing to contest this N otice. A request for an <br />inibnnal 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 oft is Notice at the foltowing address: 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />The Division Director shalt schedule a time and place for the in ilormal hearing to be conducted, which shat( be not more than <br />72 hours (exclusive of weekends) of receipt of the request for hearing. At the informal hearing the Division Director wili 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 hearin <br />This Notice shall remain in effect pending any requested hearing. <br />Th is Notice of Exclusion was delivered to the person named at the top of this Notice at the date and time shown above 'by: <br />AA <br />T7 <br />(Signature of person issuing/delivering notice) <br />I here-by acknowledge receipt of the above Notice on the date �and time indicated above. <br />(Signature of person being issued the notiec) <br />White Copy Public Works Breen Copy: Fite YeRow Copyc RepoO Copy Pink C'opv: Recipient Gold Copy: Officer Appeil nofice Rev, 1A03 <br />