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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 />[N Entering in or using all City of Eugene parks, open spaces or facilities. <br />9" <br />The basis for this Notice of Restriction of Use is that on you violated Section J-00-4009of the Park <br />and Open Space Rules, and/or Section t r 0 of the Eugene Code, 197 1, and/or ORS To wit, you: <br />PC^ 13CCoc, <br />(Description orthe violation.) <br />This restriction of use N effective beginning an �? �-z - and shall remain in effect until ALY4- <br />If you enter in or use any City of Eugene park, open space or facility during the effective period of this N otice, you may be <br />arrested and charged with criminal trespass in the second degree. <br />Pursuant to Park and Open Space Rule P -1.074 you are entitled to an info al hearing to contest this Notice. A request for as <br />informal bearing 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 Division 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 reecipt or the request For hearing, At the in ronnal hearing the Division Director will only <br />consider testimony from you, City persormel 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 effe pending any retinested hearing. <br />This Noti ca Exc I USion wag del ivered to the person named at the top of this Notice at the date and time shown above by <br />(Signature of person issuing/de , er irag oc ice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />of person being issued tv. <br />Who Copy: Public Works Gnssen Copy, Filc yullow Copy: lru'Poo Cory Vmk Copy: Rccipwt)? Gdd Copy: Offwer Ape x l notwe Rev. 04;03 <br />Marne: Lwil <br />First Middle <br />D()R� <br />Race/ses <br />1,271-1-78 W) <br />I,% J,5 ' <br />Re Address: <br />City <br />State <br />Zip <br />Res. Phone: <br />Work Phone: <br />114 <br />A <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 />[N Entering in or using all City of Eugene parks, open spaces or facilities. <br />9" <br />The basis for this Notice of Restriction of Use is that on you violated Section J-00-4009of the Park <br />and Open Space Rules, and/or Section t r 0 of the Eugene Code, 197 1, and/or ORS To wit, you: <br />PC^ 13CCoc, <br />(Description orthe violation.) <br />This restriction of use N effective beginning an �? �-z - and shall remain in effect until ALY4- <br />If you enter in or use any City of Eugene park, open space or facility during the effective period of this N otice, you may be <br />arrested and charged with criminal trespass in the second degree. <br />Pursuant to Park and Open Space Rule P -1.074 you are entitled to an info al hearing to contest this Notice. A request for as <br />informal bearing 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 Division 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 reecipt or the request For hearing, At the in ronnal hearing the Division Director will only <br />consider testimony from you, City persormel 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 effe pending any retinested hearing. <br />This Noti ca Exc I USion wag del ivered to the person named at the top of this Notice at the date and time shown above by <br />(Signature of person issuing/de , er irag oc ice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />of person being issued tv. <br />Who Copy: Public Works Gnssen Copy, Filc yullow Copy: lru'Poo Cory Vmk Copy: Rccipwt)? Gdd Copy: Offwer Ape x l notwe Rev. 04;03 <br />