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Under the authority of Administrative Order No. 5843-24-F and Park and Open Space Rule R-1.005(3 you are hereby
<br />notified that you are prohibited frorn (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 Part,
<br />and Open Space Rules, and/or Section L
<br />I J of the Eugene Code, 1971, and/or ORS To wit, you — , -Jcwq
<br />PV,-7VV:7tuc- 6CC& 7 7 PftK
<br />(Description of the violation.)
<br />This restriction of use is effective beginning on and shall retuain in effect until
<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' pace Rule R- 1.074 you are entitled to an info al hearing to contest this Notice. A request for an
<br />informal hr aning 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 of this Notice at the following address: 1820 Ron%evelf, 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 snore than
<br />72 hours (exclusive of weekends) of receipt of request for hearing. At the infori 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 />me i dent. The Division Director may exclude anyone, other than you and those presenting testimony, fro 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 of this Notice at the date and time shown above by
<br />- - -------------
<br />(Signature of person issuing/delivering notice)
<br />I hereby acknowledge receipt of the above Notice on the date and time indicated above,
<br />11 1'�70 r-rN -
<br />(Signature of person being issued the notice)
<br />pe-d nofirx k at,'O 3
<br />White Cop y: Pub I ic Works Grcen Copy: Fih� Yellow C y, op Reporr, Copy Pink Copy: Rej p ien t Gold Copy; Officer Ap
<br />Name 1,asL First Middle
<br />DOB:
<br />Racc"Sex:
<br />Res- Address�
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<br />'OR
<br />Zip
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<br />Res, 1
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<br />Work Phone:
<br />8-7 -77r U7C V
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<br />Under the authority of Administrative Order No. 5843-24-F and Park and Open Space Rule R-1.005(3 you are hereby
<br />notified that you are prohibited frorn (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 Part,
<br />and Open Space Rules, and/or Section L
<br />I J of the Eugene Code, 1971, and/or ORS To wit, you — , -Jcwq
<br />PV,-7VV:7tuc- 6CC& 7 7 PftK
<br />(Description of the violation.)
<br />This restriction of use is effective beginning on and shall retuain in effect until
<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' pace Rule R- 1.074 you are entitled to an info al hearing to contest this Notice. A request for an
<br />informal hr aning 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 of this Notice at the following address: 1820 Ron%evelf, 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 snore than
<br />72 hours (exclusive of weekends) of receipt of request for hearing. At the infori 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 />me i dent. The Division Director may exclude anyone, other than you and those presenting testimony, fro 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 of this Notice at the date and time shown above by
<br />- - -------------
<br />(Signature of person issuing/delivering notice)
<br />I hereby acknowledge receipt of the above Notice on the date and time indicated above,
<br />11 1'�70 r-rN -
<br />(Signature of person being issued the notice)
<br />pe-d nofirx k at,'O 3
<br />White Cop y: Pub I ic Works Grcen Copy: Fih� Yellow C y, op Reporr, Copy Pink Copy: Rej p ien t Gold Copy; Officer Ap
<br />
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