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(JMe, I sv�S <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 />X 11, Entering in or using all City of Eugene parks, open spaces or facilities. <br />W. <br />(Description o the violation.) <br />This restriction of use is effective beginning on a and shall remain in effect until <br />If you enter in or use. any City of Eugene park-, open Space. car 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 - you are entitled to an informal hearing to contest this Notice, A request for an <br />informal hearing must be niade in writing and filed with the Parks & Open Space Division Director ("the Division Dircetor") <br />within 48 hours (CXClLVfl VC ol'weekends) ofireceipt of this 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 hour (exclusive of weekends) of receipt eat the rVqUeSt for hearing, At the informal hearing the Division Director will only <br />consider testimony from you, City personnel involved in The incident that resulted in this Notice, and other witylesses to the <br />incident. The Division Director may exclude anyone, other than you and those presenting testimony, from the irdo rrnal 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 a Ove tyN <br />(Signature of person issuing/deliVeriDg notice) <br />I hereby acknowledge receipt of the above Notice on the date, and time indicatc,6 above. <br />Vmry <br />(Signature of person being ]qsued the nonee) <br />Wh i tc COPY: P uh I i C Woll� S Grccn cupy; File Yellow Cup y Report Copy Pink Copy: Recipient Gold Copy! Officer Appeal notice Rev- 04!03 <br />Name: Last Firs t Middle <br />V <br />[)()B <br />Race Sex: <br />Q, <br />Res. Address: Y <br />State <br />Zip <br />Res. Phone: <br />Work Phone: <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 />X 11, Entering in or using all City of Eugene parks, open spaces or facilities. <br />W. <br />(Description o the violation.) <br />This restriction of use is effective beginning on a and shall remain in effect until <br />If you enter in or use. any City of Eugene park-, open Space. car 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 - you are entitled to an informal hearing to contest this Notice, A request for an <br />informal hearing must be niade in writing and filed with the Parks & Open Space Division Director ("the Division Dircetor") <br />within 48 hours (CXClLVfl VC ol'weekends) ofireceipt of this 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 hour (exclusive of weekends) of receipt eat the rVqUeSt for hearing, At the informal hearing the Division Director will only <br />consider testimony from you, City personnel involved in The incident that resulted in this Notice, and other witylesses to the <br />incident. The Division Director may exclude anyone, other than you and those presenting testimony, from the irdo rrnal 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 a Ove tyN <br />(Signature of person issuing/deliVeriDg notice) <br />I hereby acknowledge receipt of the above Notice on the date, and time indicatc,6 above. <br />Vmry <br />(Signature of person being ]qsued the nonee) <br />Wh i tc COPY: P uh I i C Woll� S Grccn cupy; File Yellow Cup y Report Copy Pink Copy: Recipient Gold Copy! Officer Appeal notice Rev- 04!03 <br />