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NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />DATE, TIME: LTqo CASE <br />LOCATION (PA RIC'OPEN SPACE): 6, <br />Z7T_ <br />���- �� X 12..(, <br />0 <br />tinder the authority of Administrative Order o® 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 />Entering in or using all City of Eugene parks, open spaces or facilities. <br />(Description of the violation.) <br />This restriction of use is effective beginning on qqLyz - , 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 peri(,)d 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 aTe entitled to an informal hearing to contest this Notice. A request for an <br />informal hcaring 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 o f this N otice at the following address 1820 Roosevelt, Blvd., E ugene ; 0 R <br />97402. <br />The Division Director shall schedule a time avid 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 Front 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 infomial 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 cif th:is;No1i `at date and tin shown attove by <br />------------- - <br />(Signature of'person issuing/deliveri g notice) <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 />What 1,Aipy: Public WEwLl Green Copy! He Yellow Capy7 Report Copy Pink Copy! Recipient Gold Co pyi Ofti cer Appeaf non Re 04/03 <br />Name Last <br />First Middle <br />DOB� <br />RacesS <br />z <br />-Fo-t> <br />t v <br />I CK-6052�- <br />LAurzwiA L6& <br />b ol <br />U <br />LU <br />Res. Address: <br />city <br />State <br />dip <br />Res. Phone: <br />Wok Phone; <br />tinder the authority of Administrative Order o® 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 />Entering in or using all City of Eugene parks, open spaces or facilities. <br />(Description of the violation.) <br />This restriction of use is effective beginning on qqLyz - , 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 peri(,)d 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 aTe entitled to an informal hearing to contest this Notice. A request for an <br />informal hcaring 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 o f this N otice at the following address 1820 Roosevelt, Blvd., E ugene ; 0 R <br />97402. <br />The Division Director shall schedule a time avid 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 Front 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 infomial 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 cif th:is;No1i `at date and tin shown attove by <br />------------- - <br />(Signature of'person issuing/deliveri g notice) <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 />What 1,Aipy: Public WEwLl Green Copy! He Yellow Capy7 Report Copy Pink Copy! Recipient Gold Co pyi Ofti cer Appeaf non Re 04/03 <br />