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S\01 Ulu
<br />NOTICE OF RESTRICTION OF USE
<br />and Notice of Right to Appeal
<br />DATE:
<br />TIME: CASE #:
<br />LOCATION (PARKJOPEN SPACE): --- AFjjSEjjj----- "�°�' ---- ------
<br />U nder the a uthority of Admin istrative Ord er N o. -58-03-24-F a nd P a rk a nd Open Space Ru le R- 1.005(3), you a re hereby
<br />notified that you are prohibited from (check box):
<br />I
<br />Entering in or using all City of 11 geue parks, open spaces or facilities.
<br />The basis for this Notice of Restriction of Use is that on you violated Section
<br />1 _7 of the Park 10
<br />and Open Space Rules, and/or Section f �Vo -- Of the Eugene Code, 1971, and/or ORS To wit, yow
<br />At 17'�
<br />(Description of the violation.)
<br />Tbis restriction of use is effective beginning on b7t , 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 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 />in fiortnal hearing niust be made in writing and Tiled with the Parks & Open Sp ace Division Director ("the Division Director" ' )
<br />within 48 hours (eKelusive ol"weekends) of receipt of this Notice at the following addrcsq; 1820 Roosevelt, Blvd., Eugene, OR
<br />07402.
<br />T he Division Director shall schedule a time and place for the infix -al 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 �vill only
<br />consider teslimony 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 />(,Signature ol'pers( issuing/delivering notice)
<br />I hereby acknowledge receipt of the above Notice on the date and time indicated above.
<br />a °
<br />2L—
<br />(Signat re of person being Asued the notice)
<br />White Cop Public Works cheenCopy: HIC Y 0111) k� Cop : Rcpo n C UPY Pink Cupy! R.�-,cip�ent Gold Copy Officer Apped, notice Rev 04 /01
<br />Nanie: Last First Middle
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<br />Res, Address: City
<br />State
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<br />Res. Phone:
<br />Work Phone�
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<br />U nder the a uthority of Admin istrative Ord er N o. -58-03-24-F a nd P a rk a nd Open Space Ru le R- 1.005(3), you a re hereby
<br />notified that you are prohibited from (check box):
<br />I
<br />Entering in or using all City of 11 geue parks, open spaces or facilities.
<br />The basis for this Notice of Restriction of Use is that on you violated Section
<br />1 _7 of the Park 10
<br />and Open Space Rules, and/or Section f �Vo -- Of the Eugene Code, 1971, and/or ORS To wit, yow
<br />At 17'�
<br />(Description of the violation.)
<br />Tbis restriction of use is effective beginning on b7t , 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 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 />in fiortnal hearing niust be made in writing and Tiled with the Parks & Open Sp ace Division Director ("the Division Director" ' )
<br />within 48 hours (eKelusive ol"weekends) of receipt of this Notice at the following addrcsq; 1820 Roosevelt, Blvd., Eugene, OR
<br />07402.
<br />T he Division Director shall schedule a time and place for the infix -al 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 �vill only
<br />consider teslimony 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 />(,Signature ol'pers( issuing/delivering notice)
<br />I hereby acknowledge receipt of the above Notice on the date and time indicated above.
<br />a °
<br />2L—
<br />(Signat re of person being Asued the notice)
<br />White Cop Public Works cheenCopy: HIC Y 0111) k� Cop : Rcpo n C UPY Pink Cupy! R.�-,cip�ent Gold Copy Officer Apped, notice Rev 04 /01
<br />
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