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 />Entering in or using all City of Eugene parks, open spaces or facilities. <br />El <br />The basis for this Notice of Restriction of Use is that on you violated Section L O - 1 D-u0tof the Park <br />and Open Space Rules, and/or Section ' 77 0 of the Eugene Code, 1971, and/or ORS To wit, you: <br />L ) 9JW07-t4- :4W P?MK <br />(.Description of the violation.) <br />This restriction of use is rMctive beginning on VIVILL-1 and $hall remain in effect until] <br />If you enter in or use any City ol'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 />The Division Director sha 11 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, frorn 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 />( 'eigena of e person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />Vz AF () <br />(Signature of person being issued the notice) <br />White Copy, Public Works Green Copy: File Yellow COPY! Repon Copy Pink Uopy: Rcoipient Gold Copy: 0 M cer Appeal not Rm tA/03 <br />''Janie:: Last First j\ addle <br />DOB <br />Race/sex: <br />- 7c < <br />Re-s - Akldros; City <br />State 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 />Entering in or using all City of Eugene parks, open spaces or facilities. <br />El <br />The basis for this Notice of Restriction of Use is that on you violated Section L O - 1 D-u0tof the Park <br />and Open Space Rules, and/or Section ' 77 0 of the Eugene Code, 1971, and/or ORS To wit, you: <br />L ) 9JW07-t4- :4W P?MK <br />(.Description of the violation.) <br />This restriction of use is rMctive beginning on VIVILL-1 and $hall remain in effect until] <br />If you enter in or use any City ol'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 />The Division Director sha 11 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, frorn 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 />( 'eigena of e person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />Vz AF () <br />(Signature of person being issued the notice) <br />White Copy, Public Works Green Copy: File Yellow COPY! Repon Copy Pink Uopy: Rcoipient Gold Copy: 0 M cer Appeal not Rm tA/03 <br />