New Search
6%A4 1�b� CK) <br />- -------------------------- - - <br />Under the authority of Administrative Order No. 58-03-24-F and Park and Open Space Rule R4.005(3), you are hereby <br />notified that you are prohibited from (check box,)- <br />,Z 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 m o you violated Section 1 6 of the Park <br />and Open Space Rales, and/or Section of the Eugene Code, 1971 a and/or ORS To wit, you: <br />(Description of the violation.) <br />This restriction of use is effective beginning on o96 and shall remain 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 Space Rule R-1.®74 you are entitled to an informal hearing to contest this Notlee, 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 of this Notice at the following address: 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />72 hours f ex el u-si ve of week en ds) of recei pt of th e reguest for heaning A t th e i n fo r va I heari n Q n. <br />the Division Director wi I I ojn <br />consider testimony from you, City personnel involved in the incident that resulted in this Notice, and other witnesses to t <br />incidea The Division Director may exclude anyone, other than you and those presenting testimony,, from the informal hearin <br />'!'his 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 Ndr?c at the date and time shown above by: <br />/0� IAMI <br />(Sig�ntore ot'pirson issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />(Sig <br />White Copy: Pub ic Work s Grecn Copy: File Yellow Copy: Repoil Copy Pink Ct,py: Re(:jpjCnt Gold Copy, Offic er Appeal no t ic e Rev. 04/01 <br />'fit ine: Last First middle <br />DOB: <br />Race/ sev <br />f. <br />AA VC <br />Address <br />Res, C t� <br />St to <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 R4.005(3), you are hereby <br />notified that you are prohibited from (check box,)- <br />,Z 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 m o you violated Section 1 6 of the Park <br />and Open Space Rales, and/or Section of the Eugene Code, 1971 a and/or ORS To wit, you: <br />(Description of the violation.) <br />This restriction of use is effective beginning on o96 and shall remain 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 Space Rule R-1.®74 you are entitled to an informal hearing to contest this Notlee, 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 of this Notice at the following address: 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />72 hours f ex el u-si ve of week en ds) of recei pt of th e reguest for heaning A t th e i n fo r va I heari n Q n. <br />the Division Director wi I I ojn <br />consider testimony from you, City personnel involved in the incident that resulted in this Notice, and other witnesses to t <br />incidea The Division Director may exclude anyone, other than you and those presenting testimony,, from the informal hearin <br />'!'his 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 Ndr?c at the date and time shown above by: <br />/0� IAMI <br />(Sig�ntore ot'pirson issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />(Sig <br />White Copy: Pub ic Work s Grecn Copy: File Yellow Copy: Repoil Copy Pink Ct,py: Re(:jpjCnt Gold Copy, Offic er Appeal no t ic e Rev. 04/01 <br />