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U nder the authority o f A druinistrative Ord er No. 58-03-24-F and Park an d Open Spa cc Rule R- 1.005(3), you a re hereby <br />notified that you, are prohibited from (check box): <br />Entering in or using all City of Eugene parks, open spaces or facilities, <br />a <br />The basis for this Notice of Restriction of Use is that on C9 — oz t you violated Section of the Park <br />and Open Space Mule /or Sect q <br />of the Eugene Code, 197 1, and/or ORS To wit, you: <br />m. — <br />(Description of the violation.) <br />This restriction of use is effective beginning on 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 />1���LIUFAVC Ul 77C <br />consider testimony from you, City personnel involved in the incident that resulted in this Notice, and other witnesses to t <br />sse o <br />i ncident. The Di vi slon Director may exclude anyone, other than y ou. and those presenting testimony, from the in formna I jh�earin <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 Lit the date and time shown above by: <br />L <br />6 �) <br />(Signature of person issuing/defivering, notice) <br />g <br />Nanie: Last First Middle <br />DOB: <br />Raceis <br />rA kTT 4EAJ TkAA6fz) <br />Res koldress: city <br />State <br />� Zip lRes, <br />fPhone <br />Work Phone: <br />U nder the authority o f A druinistrative Ord er No. 58-03-24-F and Park an d Open Spa cc Rule R- 1.005(3), you a re hereby <br />notified that you, are prohibited from (check box): <br />Entering in or using all City of Eugene parks, open spaces or facilities, <br />a <br />The basis for this Notice of Restriction of Use is that on C9 — oz t you violated Section of the Park <br />and Open Space Mule /or Sect q <br />of the Eugene Code, 197 1, and/or ORS To wit, you: <br />m. — <br />(Description of the violation.) <br />This restriction of use is effective beginning on 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 />1���LIUFAVC Ul 77C <br />consider testimony from you, City personnel involved in the incident that resulted in this Notice, and other witnesses to t <br />sse o <br />i ncident. The Di vi slon Director may exclude anyone, other than y ou. and those presenting testimony, from the in formna I jh�earin <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 Lit the date and time shown above by: <br />L <br />6 �) <br />(Signature of person issuing/defivering, notice) <br />g <br />