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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 />El <br />The basis for this Notice of Restriction of Use is that on -1 you violated Section of the Park. <br />-* i o t <br />and Open Space Rules, and/or Section 4. lqo of the Eugene Code, 1971, and/or ORS To wit, You.-IL!KA6 <br />;75� oi- htj 01"Cro 5 kcsckvc <br />(Description of the violation.) <br />This restriction o ar is begin <br />us effe <br />ctive <br />ning on. and shall remain in effect until <br />If you enter in or use any City of Eugene park, opera 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. A request For an <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 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) of receipt of the request for hearing. At the infi - M - nal 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 shall remain in effect pending any requested hearing, <br />This Notice of Exclusion was delivered to the person named at the top of this Notice at the date and tinie shown above by: <br />(Signature of person issuing/delivering notice) <br />I hereby acknowledge neccipt of the above Notice on the date and time indicated above. <br />(Signature of person being issued the notice) <br />Whitt Copy: Public WorL, Greo CopyL Nic 'edlaw Copy: Report Cop Pink Copy; Recipient Gold Ccpy� Officer AppeA noliec Rev, 1,4�03 <br />Naine_ Last First MiddIc <br />D( 7 <br />Race /sex� <br />- ZIR PI - ftSS C <br />Re Add m,&� City <br />Stale <br />Zip <br />Res p honi�� <br />wc � rk Phone: <br />— ------ . . ................... <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 />El <br />The basis for this Notice of Restriction of Use is that on -1 you violated Section of the Park. <br />-* i o t <br />and Open Space Rules, and/or Section 4. lqo of the Eugene Code, 1971, and/or ORS To wit, You.-IL!KA6 <br />;75� oi- htj 01"Cro 5 kcsckvc <br />(Description of the violation.) <br />This restriction o ar is begin <br />us effe <br />ctive <br />ning on. and shall remain in effect until <br />If you enter in or use any City of Eugene park, opera 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. A request For an <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 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) of receipt of the request for hearing. At the infi - M - nal 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 shall remain in effect pending any requested hearing, <br />This Notice of Exclusion was delivered to the person named at the top of this Notice at the date and tinie shown above by: <br />(Signature of person issuing/delivering notice) <br />I hereby acknowledge neccipt of the above Notice on the date and time indicated above. <br />(Signature of person being issued the notice) <br />Whitt Copy: Public WorL, Greo CopyL Nic 'edlaw Copy: Report Cop Pink Copy; Recipient Gold Ccpy� Officer AppeA noliec Rev, 1,4�03 <br />