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1.2 h N <br />NOTICE OF RESTRICTION OF USE <br />and Notice of Fight to ,appeal <br />TIME: CASE 4 <br />LOCATION (P ,'OPEN SP CF); ..-- <br />Linder the authority of administrative Order No. 58-03-24-F and Park and Open Space Kale R-1.005(3), you sire hereby <br />notified tha you are p rohibited from (check box): <br />Entering in or "sing all City of Eugene parks, open spaces or facilities. <br />X <br />If you enter in or use any City of Eugene park, open space or facility during the effective period oft is Notice, you may be <br />arrested and charged with criminal trespass in the second degree. <br />Pursuant to Park and Open Space Rule ft. -1,074 you are entitled to an informal hearing to contest this Notice.. request for an <br />informal hearing must be made in w=riting 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 folio+ ing address: 1820 Roosevelt., Blvd., Eugene, OR <br />7402. <br />The Division Director shall schedule a tim 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 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, ether 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 ate and time tihcwvrt above by: <br />(Signature of person issuing delivering notice <br />I hereby acknowledge receipt of the above Notice on the date and time ittdie at c �� . <br />( Signature of`person being issued the notice) <br />White Copy: Public Works green Copy: He Yellow Copy Report Copy Pink COPY: Recipient Gold Copy: officer Appeal rwtice Rev. 041'03 <br />'anal Last First Middle <br />ttasea <br />ce/ <br />f! W � <br />. <br />Res, Address` Citv <br />t <br />swe <br />Zip <br />Res. Phone! <br />Work Phone: <br />Linder the authority of administrative Order No. 58-03-24-F and Park and Open Space Kale R-1.005(3), you sire hereby <br />notified tha you are p rohibited from (check box): <br />Entering in or "sing all City of Eugene parks, open spaces or facilities. <br />X <br />If you enter in or use any City of Eugene park, open space or facility during the effective period oft is Notice, you may be <br />arrested and charged with criminal trespass in the second degree. <br />Pursuant to Park and Open Space Rule ft. -1,074 you are entitled to an informal hearing to contest this Notice.. request for an <br />informal hearing must be made in w=riting 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 folio+ ing address: 1820 Roosevelt., Blvd., Eugene, OR <br />7402. <br />The Division Director shall schedule a tim 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 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, ether 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 ate and time tihcwvrt above by: <br />(Signature of person issuing delivering notice <br />I hereby acknowledge receipt of the above Notice on the date and time ittdie at c �� . <br />( Signature of`person being issued the notice) <br />White Copy: Public Works green Copy: He Yellow Copy Report Copy Pink COPY: Recipient Gold Copy: officer Appeal rwtice Rev. 041'03 <br />