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NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />P <br />LOCATION (PARKJOPEN S PACE) <br />"A <�(- <br />Under the authority of. d inistrative Order No. 58-03-24-F and Park and Open Space Rule - 1.005(' , you are hereby <br />notified that you are prohibited from (check box): <br />d Entering in or using all City of Eugene parks, open spaces or facilities. <br />El <br />(Description of the violation.) <br />This restriction of use is effective beginning on and shall remain in effect until - & I <br />L - <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 :P to I2 -I.074 you are entitled to an informal hearing to contest this Notice, A request for an <br />info al hearing must be, made in writing and filed with the Parks & Open Space Division Director ("the Division Dircclor") <br />with 48 hours (exclusive of weekends) of receipt ofthis 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) ofTeeeipt 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, other than you and those presenting testimony, from the info al 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 oil' this Notice at the date and time shown above by-, <br />:7 <br />(SignaklrC of person issuzrrgh e lvering 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 />White Copy: Public Work-b CaYs i Copy: File Yellow Copy: Report Copy Pink Cripy: Recipient Gold Copy: Officer .fig pc� notice ke 04. 1 <br />Name: Last First Middle <br />DO <br />Ra2i <br />14AR-3 Y I VCN JA4W <br />L4 0 L <br />I: <br />An <br />;f <br />Res. Address: Ci ty —FT <br />is <br />Res, Plwne: <br />Work Phone: <br />Under the authority of. d inistrative Order No. 58-03-24-F and Park and Open Space Rule - 1.005(' , you are hereby <br />notified that you are prohibited from (check box): <br />d Entering in or using all City of Eugene parks, open spaces or facilities. <br />El <br />(Description of the violation.) <br />This restriction of use is effective beginning on and shall remain in effect until - & I <br />L - <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 :P to I2 -I.074 you are entitled to an informal hearing to contest this Notice, A request for an <br />info al hearing must be, made in writing and filed with the Parks & Open Space Division Director ("the Division Dircclor") <br />with 48 hours (exclusive of weekends) of receipt ofthis 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) ofTeeeipt 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, other than you and those presenting testimony, from the info al 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 oil' this Notice at the date and time shown above by-, <br />:7 <br />(SignaklrC of person issuzrrgh e lvering 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 />White Copy: Public Work-b CaYs i Copy: File Yellow Copy: Report Copy Pink Cripy: Recipient Gold Copy: Officer .fig pc� notice ke 04. 1 <br />