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LOCATION (PARK/OPEN SPACE) AA L-f— M 9 - )Q <br />Under the authority of Administrative Order No. 58-03-24-F and Parkand Open SpaceRule R-1.005(3),vou are hereby <br />notified that you are prohibited from (check box): <br />aw Entering in or using all City of Eugene park%, open spaces or facilitioi. <br />0 <br />The basis for this Notice of Restriction of Use is that on you violated Section 6 L f)f the Park <br />and Open Space Rules, and/or Section of the Eugene Code, 1971, and/or ORS -. To wit, you:_ <br />(Description of the violation.) <br />This restriction of use is effective beginning on d4n 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 pule R- 1,1174 you are entitled to an informal hearing to contest this Notice. A request for an <br />informal hearing must be made in writing and riled 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. 1920 Roosevelt, Blvd., Engene, 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 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 witnesses to the <br />incident. The Division Director may exclude anyone, other than you and those presenting testimony, from 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 time shown above by: <br />--4 -X—X - -- — - - - — --------------------------- ---- ( Signature of person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and tine indicated above. '19 t lol <br />(Signature of person being issued the notice) <br />Whiu: Copy: Public Workti Careen Copy: Filc Yellow Copy: Report Copy Pink Copy Recipient Guld Copy: Offlccr Appeal maik„c pct, (4 03 <br />Name: Last First Middit <br />D(),M <br />Race" <br />- 2A?v cj V I <br />Res. Address: city <br />State <br />Fz I P <br />Res, Phone: <br />Work Phone: <br />Under the authority of Administrative Order No. 58-03-24-F and Parkand Open SpaceRule R-1.005(3),vou are hereby <br />notified that you are prohibited from (check box): <br />aw Entering in or using all City of Eugene park%, open spaces or facilitioi. <br />0 <br />The basis for this Notice of Restriction of Use is that on you violated Section 6 L f)f the Park <br />and Open Space Rules, and/or Section of the Eugene Code, 1971, and/or ORS -. To wit, you:_ <br />(Description of the violation.) <br />This restriction of use is effective beginning on d4n 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 pule R- 1,1174 you are entitled to an informal hearing to contest this Notice. A request for an <br />informal hearing must be made in writing and riled 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. 1920 Roosevelt, Blvd., Engene, 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 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 witnesses to the <br />incident. The Division Director may exclude anyone, other than you and those presenting testimony, from 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 time shown above by: <br />--4 -X—X - -- — - - - — --------------------------- ---- ( Signature of person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and tine indicated above. '19 t lol <br />(Signature of person being issued the notice) <br />Whiu: Copy: Public Workti Careen Copy: Filc Yellow Copy: Report Copy Pink Copy Recipient Guld Copy: Offlccr Appeal maik„c pct, (4 03 <br />