NOTICE OF RESTRICTION OF USE Nn � tw c nu <br />TIME: <br />LOCATION (PAR /OPEN SPACE) <br />DATE. <br />and Notice of Right to Appeal <br />3 PrA CASE#: <br />-------- --- <br />0 o kp 3 <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 />Entering in or using all City of Eugene parks, open spHces or facilities. <br />The basis for this Notice of Restriction of Use is that on you violated Section t the Park <br />and Open Space Rules, and/or Section oftbe Eugene Code, 1971, and/or ORS To wit, you:_ <br />ID JM & WRL <br />(Description of the violation.) <br />This restriction of use is effective beginning on 31-/y and shall remain in effect until <br />k:m � <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 Rule R-1,074 you are entitled to an informal hearing to contest this Notice. Arequest fear art <br />informal hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />within 48 hours (exclusive ofweekends) of'receipt ofthis Notice at the following address: 1920 Roosevelt, Blvd., Eugene, OR <br />97401 <br />"IVISIVII LJHM�931 Nnuki SLIiCUUM a UJIM MICI ITT ill Lite, miormal nearing 10 ne Coll u 7, TMun sna De not more 7M7 <br />72 hours (excl usive of weekends) of recei pt of the requ est for hearing. At the informal h earing the Division Director wi 11 only <br />consider testimony hrom you, City personnel involved in the incident that resulted in this Notice, and other witnesses to the <br />i ncident. The Di vision Di rector may excl ude anyone, other than you and those presenting testimony, from the infort hearing. <br />This Notice shall rernain in effect pending any requested hearing. <br />This Notice of Exclusion wm 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 noticc) <br />Name: Last First M e <br />DOB: <br />Race/ Se <br />z <br />Pub <br />0 <br />L� <br />Res Address: <br />J city <br />Mate <br />i <br />Zip <br />7- <br />Res, Phone: <br />Work Phone: <br />IP' I <br />INS i <br />I <br />- <br />0 o kp 3 <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 />Entering in or using all City of Eugene parks, open spHces or facilities. <br />The basis for this Notice of Restriction of Use is that on you violated Section t the Park <br />and Open Space Rules, and/or Section oftbe Eugene Code, 1971, and/or ORS To wit, you:_ <br />ID JM & WRL <br />(Description of the violation.) <br />This restriction of use is effective beginning on 31-/y and shall remain in effect until <br />k:m � <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 Rule R-1,074 you are entitled to an informal hearing to contest this Notice. Arequest fear art <br />informal hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />within 48 hours (exclusive ofweekends) of'receipt ofthis Notice at the following address: 1920 Roosevelt, Blvd., Eugene, OR <br />97401 <br />"IVISIVII LJHM�931 Nnuki SLIiCUUM a UJIM MICI ITT ill Lite, miormal nearing 10 ne Coll u 7, TMun sna De not more 7M7 <br />72 hours (excl usive of weekends) of recei pt of the requ est for hearing. At the informal h earing the Division Director wi 11 only <br />consider testimony hrom you, City personnel involved in the incident that resulted in this Notice, and other witnesses to the <br />i ncident. The Di vision Di rector may excl ude anyone, other than you and those presenting testimony, from the infort hearing. <br />This Notice shall rernain in effect pending any requested hearing. <br />This Notice of Exclusion wm 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 noticc) <br />