New Search
N e <br />NOTICE OF RESTRICTION OF USE iq - tLLqS <br />and Notice of Right to Appeal <br />DATE: 07 n 1 2o H TIME: [ <br />_H CASE #: t tz <br />-- - ------------- - ----- <br />LOCATION l ARK/OPEN SPACE): <br />U nder the authority o Administrative Order No. 58-03-24- F and Park and Open Space Rule R - 1.0 ), 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 />The basis for this Notice of Restriction of Use is that on D DZ_ t you violated Section 1, Ot (JA of the Park <br />and Open Space Rules, andlor Section IJ �0 of the Eugene Code, 1971, andJor ORS To wit, you: <br />(DegcYlption of the violation.) <br />This restriction of use is effective beginning on and shall remain in effect until d <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 for an <br />informal hearing must be made In writing and filed with the Parks & Open Space Division Director ( ' " ') <br />the Division Directoe <br />within 48 hours (exclusive of weekends) of receipt of this Notice at the Following address 1820 Roosevelt, Blvd., Eimgene, OR <br />97402. <br />The Division Director shall schedule a time and place for the informal hearing to be conducted, which shall be not 1nore 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 req"ested 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 />(Signature of person issuing/delivering notice) <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 />Whil c Copy ; P ab I i Work � Green Copy: FAc y0kny (. upy: kq)ort Copy Pink Copy" Recipient Gold Copy Offim App.a� nofict Rib (A`03 <br />Name: Last First Middle <br />DOB: <br />Race/Sex: <br />Res, Address: city <br />State <br />Zip <br />Res. Phune: <br />Work Phme. <br />U nder the authority o Administrative Order No. 58-03-24- F and Park and Open Space Rule R - 1.0 ), 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 />The basis for this Notice of Restriction of Use is that on D DZ_ t you violated Section 1, Ot (JA of the Park <br />and Open Space Rules, andlor Section IJ �0 of the Eugene Code, 1971, andJor ORS To wit, you: <br />(DegcYlption of the violation.) <br />This restriction of use is effective beginning on and shall remain in effect until d <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 for an <br />informal hearing must be made In writing and filed with the Parks & Open Space Division Director ( ' " ') <br />the Division Directoe <br />within 48 hours (exclusive of weekends) of receipt of this Notice at the Following address 1820 Roosevelt, Blvd., Eimgene, OR <br />97402. <br />The Division Director shall schedule a time and place for the informal hearing to be conducted, which shall be not 1nore 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 req"ested 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 />(Signature of person issuing/delivering notice) <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 />Whil c Copy ; P ab I i Work � Green Copy: FAc y0kny (. upy: kq)ort Copy Pink Copy" Recipient Gold Copy Offim App.a� nofict Rib (A`03 <br />