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LOCATION WARKJOPEN 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 />V- 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 Mac?--, you violated Section of the Park,
<br />and Open Sp and/or Section 4 4, t of the Eugene Code, 1971, and/or ORS To wit., you:_
<br />(Description of the violation.)
<br />This restriction. of use is effective beginning on Ma), 4 � a ad shall remain in effect until 0
<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 info al 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 ("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 />RI]L L"a"Imun RJULRH NHU I hL11H:UU Kkilld I ; I lo Lju L;Vj1UUULk;U, wmul slEdu W Elm, mugu LENIN
<br />72 hours (exclusive of weekends) of receipt rifthe 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 />ineidenL The Division Director may exclude anyone, other than you and those presenting testimony, frorn the infortrial hearing.
<br />This Notice shall rernain in effect pending any requested bearing.
<br />This Notice of Exclusion was delivered to the person named at the top ofthils Noli L '0 date and firric shown, above by
<br />IV
<br />(Signature of person NSUing/ deli vering nonce)
<br />cl
<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 />lhla Cipy Pt�bh�; Work, GrccnCup i Fik-. Y d k, % Copy Repo rE C opy Nak Copy, R mpicnl Gold Copy Offlicer Appcad notice Rev, OW03
<br />Name Lai[ First Middle
<br />DOB:
<br />Ra
<br />a.
<br />U
<br />U�
<br />Res, d -ssi City
<br />State Zip
<br />Res, Phone:
<br />Work Phone
<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 />V- 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 Mac?--, you violated Section of the Park,
<br />and Open Sp and/or Section 4 4, t of the Eugene Code, 1971, and/or ORS To wit., you:_
<br />(Description of the violation.)
<br />This restriction. of use is effective beginning on Ma), 4 � a ad shall remain in effect until 0
<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 info al 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 ("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 />RI]L L"a"Imun RJULRH NHU I hL11H:UU Kkilld I ; I lo Lju L;Vj1UUULk;U, wmul slEdu W Elm, mugu LENIN
<br />72 hours (exclusive of weekends) of receipt rifthe 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 />ineidenL The Division Director may exclude anyone, other than you and those presenting testimony, frorn the infortrial hearing.
<br />This Notice shall rernain in effect pending any requested bearing.
<br />This Notice of Exclusion was delivered to the person named at the top ofthils Noli L '0 date and firric shown, above by
<br />IV
<br />(Signature of person NSUing/ deli vering nonce)
<br />cl
<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 />lhla Cipy Pt�bh�; Work, GrccnCup i Fik-. Y d k, % Copy Repo rE C opy Nak Copy, R mpicnl Gold Copy Offlicer Appcad notice Rev, OW03
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