|
NOTICE OF RESTRICTION OF USE
<br />and Notice of Right to Appeal
<br />DATE: 0_74�tlil_ TIME: CASE
<br />LOCATION (PAMC/OPE�N MIME):
<br />�I IM D
<br />� &V i t
<br />Under the authorit of Administrative Order No. 58-03-24-F and Park and Open Space Rule R-1.005(3), you are hereby
<br />Y
<br />notified that you are prohibited from (check box).
<br />Entering in or using all City of Eugene parks, open spaces or facilities.
<br />The basis for this Notice of Restriction of Use is that on you violated Section of the Park
<br />and Open Space Rules, and/or Section 4.190 of the Eugene Code, 1971, and/orORS_ To wit, you:-
<br />f"c 6COS-5 j67 0 Ir- 8(AA
<br />P- -
<br />(Description of the violation.)
<br />This restriction of use is effective beginning on 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 period of thiLq 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 are entitled to an informal hearing to contest this Notice. A request For an
<br />informal hearing must be trade in writing and filed with the parks & Open Space Division Director ("the Division Director")
<br />within d hours (exclusive of weekends) of receipt of this Notice at the fo address: 1820 Roosevelt, Blvd., E ugene, 0 R
<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 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. The Division Director may exclude anyone, other than you and those presenting testimony, ftorn the informal hearing.
<br />This Notice shrill remain in effect pending any requested hearing.
<br />This Notice (if Exclusion was delivered to the person named at the top of this Notice at the date and time shown above by-,
<br />- --------- :_!�, ---------- - ----------- (Signature of person issuing/defivering notice)
<br />I hereby acknowledge receipt of the above Notice on the date and time indicated above.
<br />6 61 Oqrg
<br />(Signature of person being issued the notice)
<br />What/ Copy, Public Works Oteen copy File Yellow Copy: Repml Copy Pink Copy, Recipicni Gold Co y; Offs yea" Appe, nuficz Rev ,04!03
<br />Name: Last F i rs I Middle
<br />DOB:
<br />Race/Sev
<br />0SOiQ1
<br />6 F
<br />Res, Address: City
<br />Et
<br />Zip
<br />Res. Phone:
<br />Work Phon e:
<br />Under the authorit of Administrative Order No. 58-03-24-F and Park and Open Space Rule R-1.005(3), you are hereby
<br />Y
<br />notified that you are prohibited from (check box).
<br />Entering in or using all City of Eugene parks, open spaces or facilities.
<br />The basis for this Notice of Restriction of Use is that on you violated Section of the Park
<br />and Open Space Rules, and/or Section 4.190 of the Eugene Code, 1971, and/orORS_ To wit, you:-
<br />f"c 6COS-5 j67 0 Ir- 8(AA
<br />P- -
<br />(Description of the violation.)
<br />This restriction of use is effective beginning on 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 period of thiLq 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 are entitled to an informal hearing to contest this Notice. A request For an
<br />informal hearing must be trade in writing and filed with the parks & Open Space Division Director ("the Division Director")
<br />within d hours (exclusive of weekends) of receipt of this Notice at the fo address: 1820 Roosevelt, Blvd., E ugene, 0 R
<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 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. The Division Director may exclude anyone, other than you and those presenting testimony, ftorn the informal hearing.
<br />This Notice shrill remain in effect pending any requested hearing.
<br />This Notice (if Exclusion was delivered to the person named at the top of this Notice at the date and time shown above by-,
<br />- --------- :_!�, ---------- - ----------- (Signature of person issuing/defivering notice)
<br />I hereby acknowledge receipt of the above Notice on the date and time indicated above.
<br />6 61 Oqrg
<br />(Signature of person being issued the notice)
<br />What/ Copy, Public Works Oteen copy File Yellow Copy: Repml Copy Pink Copy, Recipicni Gold Co y; Offs yea" Appe, nuficz Rev ,04!03
<br />
|