NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />DATE: TIME eg-�;o 4, CASE #- <br />LOCATION (PARK, SPACE): k-1'4 --r ; <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 />0- Entering in or using all City of Fu gene parks, open spaces or facilities. <br />The basis for this Notice of Restriction of Use is that on r you violated Section Z d 16 of the Park <br />(Description of the violation.) <br />This restriction of use is effective beginning on and shall reanain 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 It -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 ("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 Divi%ion Director shall schedule a time and place for the informal 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 info al 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. Th D1 v 1 q ion Director may exclude anyone, other than you and those presenting testimony„ frorn the info ial heari ng, <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 />R Cyr <br />----- - ----- <br />(Signature of person issuing/delivering - notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />(Si'gnaturc of person being issued the notice) <br />Whitc Cop, Puhliv Work5 G-rc�m Cupy.: HIC Ycflow Cupy� RrPoll COPY P ink C opv� Rec i p ient Go ld Co y! 0 M cer Appeal notice Rr , ,, WAY; <br />'carne: Last First MidEfle <br />DOB� <br />Race/Sex: <br />If4A 6 r <br />Res, Address. City <br />State <br />Zip <br />Res. Phone <br />Work Phone: <br />�ZA� <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 />0- Entering in or using all City of Fu gene parks, open spaces or facilities. <br />The basis for this Notice of Restriction of Use is that on r you violated Section Z d 16 of the Park <br />(Description of the violation.) <br />This restriction of use is effective beginning on and shall reanain 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 It -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 ("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 Divi%ion Director shall schedule a time and place for the informal 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 info al 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. Th D1 v 1 q ion Director may exclude anyone, other than you and those presenting testimony„ frorn the info ial heari ng, <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 />R Cyr <br />----- - ----- <br />(Signature of person issuing/delivering - notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />(Si'gnaturc of person being issued the notice) <br />Whitc Cop, Puhliv Work5 G-rc�m Cupy.: HIC Ycflow Cupy� RrPoll COPY P ink C opv� Rec i p ient Go ld Co y! 0 M cer Appeal notice Rr , ,, WAY; <br />