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NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />rk <br />L <br />DATF 1 W A lAt TIML CASE #: <br />01 <br />LOCATION ( PARKIOPEN SPACE): <br />Under the authority of Administrative Order No. 58-03-24-F and Park and OpenSpace Rule R-1.005(3), you are hereby <br />notified that you are prohibited from (check box): <br />�K 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 FAC/ q . you violated Section -LID _ 1#9 the Park <br />and Open Space Rules, and/or Section of the Eugene Code, 1971, and/or ORS To wit, you: (lickc- <br />(Description of the violation.) <br />This restriction of use is effective beginning on x!a . and shall remain in effect until <br />If you crater 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 />Cff ISTIMT pdUu AMIC PC- I.L) 7 -T you ala MRILICUMU all Inful Inal Cullies lNunce. ft FC4 <br />informal hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Director <br />wiittiri 49 hour-, iexchicive of weekendsl of r owimr I - I <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 wituesseq 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 waq delivered to the person named at the top of this Notice at the date and time shown above by: <br />(Signature of person issming/delivering <br />I hereby acknowledge receipt of the above Notice on the date and thne indicated above. <br />-- - ---- ----- <br />(Signature of person being issued the notice) <br />Witte Copy: Puhl ic Wo rk., Cm n Copy! File YvIlow Copy: Repirt Copy Pink C opy : Rec ip eent gold Copy: Cl fficer Appea notice Re % OW03 <br />Name: Last Fiat Middle <br />DOB� <br />Race. <br />Re Addres.�,: City <br />State <br />Zip <br />Res- Plione: <br />Work <br />'Cl - 74 YJ <br />Under the authority of Administrative Order No. 58-03-24-F and Park and OpenSpace Rule R-1.005(3), you are hereby <br />notified that you are prohibited from (check box): <br />�K 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 FAC/ q . you violated Section -LID _ 1#9 the Park <br />and Open Space Rules, and/or Section of the Eugene Code, 1971, and/or ORS To wit, you: (lickc- <br />(Description of the violation.) <br />This restriction of use is effective beginning on x!a . and shall remain in effect until <br />If you crater 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 />Cff ISTIMT pdUu AMIC PC- I.L) 7 -T you ala MRILICUMU all Inful Inal Cullies lNunce. ft FC4 <br />informal hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Director <br />wiittiri 49 hour-, iexchicive of weekendsl of r owimr I - I <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 wituesseq 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 waq delivered to the person named at the top of this Notice at the date and time shown above by: <br />(Signature of person issming/delivering <br />I hereby acknowledge receipt of the above Notice on the date and thne indicated above. <br />-- - ---- ----- <br />(Signature of person being issued the notice) <br />Witte Copy: Puhl ic Wo rk., Cm n Copy! File YvIlow Copy: Repirt Copy Pink C opy : Rec ip eent gold Copy: Cl fficer Appea notice Re % OW03 <br />