Under the authority of Administrative Order No. 58-03-24-F and Park and Open Space Rule R-1.0050), you are hereby <br />notified that you are prohibited from (check box): <br />9 C Entering in or using all City of Eugene parks, open spaces or facilities. <br />r <br />The basis for this Notice of Restriction of Use is that on -:7 3 <br />you violated Section 13 (ko of the Park <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 I'lark 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 made in writing and filed with the Parks & Open Space Division Director ("the Division DixectoC') <br />within 49 hours (exclusive of weekends) of receipt of this Notice at the following address: 1820 Roosevelt, Blvd., Eugene, OR <br />97401 <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 o f the request for hearing. At the informa I hearing the Division Director wi I I only <br />consider testimony from you, City personnel involved in the incident that resulted in this Notice, and other witnesse's, 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 effect pending any requested hearing. <br />This Notice ol' pace lesion 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/delivering notice) <br />1 hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />M <br />(Signature of person being issued the notice) <br />Wh i Ic Copy� Pu W ic \V ovks GrcenC(-7j: File YCHO'N Calpy: Reporl Copy Pink Copy: Redrwmt (3 "Id C, Ipy :: 0 ff'WCT Appeal notice Rxv� 04/03 <br />Name Last <br />First Middle <br />DOB� <br />Race"`Sexa <br />C IDL-c <br />Res. Addmss: <br />I. le <br />Zip <br />I <br />Res, Phone: <br />Work Phone: <br />I— A <br />111= <br />- <br />Under the authority of Administrative Order No. 58-03-24-F and Park and Open Space Rule R-1.0050), you are hereby <br />notified that you are prohibited from (check box): <br />9 C Entering in or using all City of Eugene parks, open spaces or facilities. <br />r <br />The basis for this Notice of Restriction of Use is that on -:7 3 <br />you violated Section 13 (ko of the Park <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 I'lark 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 made in writing and filed with the Parks & Open Space Division Director ("the Division DixectoC') <br />within 49 hours (exclusive of weekends) of receipt of this Notice at the following address: 1820 Roosevelt, Blvd., Eugene, OR <br />97401 <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 o f the request for hearing. At the informa I hearing the Division Director wi I I only <br />consider testimony from you, City personnel involved in the incident that resulted in this Notice, and other witnesse's, 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 effect pending any requested hearing. <br />This Notice ol' pace lesion 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/delivering notice) <br />1 hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />M <br />(Signature of person being issued the notice) <br />Wh i Ic Copy� Pu W ic \V ovks GrcenC(-7j: File YCHO'N Calpy: Reporl Copy Pink Copy: Redrwmt (3 "Id C, Ipy :: 0 ff'WCT Appeal notice Rxv� 04/03 <br />