New Search
NOTICE OF RESTRICTION OF USE <br /> and Notice ofRight to Appeal <br /> DATE: e? D/' / � ` TIME: / CASE #: / 3 f 3 • • LOCATION (PARK/OPEN SPACE): /,/1 /L A/ . .4 /j e % AW A'De � <br /> F Name: Last First Middle DOB: Race /Sex: <br /> (2416 WC4 IV A20 40 - 1 <br /> Res. Address: City State Zip Res. Phone: Work Phone: <br /> 45 1/74Ls /L &,G1 , U.E vA Y71/46 <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 /> D <br /> The basis for this Notice of Restriction of Use is that on d - / , you violated Section - 1? of the Park <br /> and Open Space Rules, and/or Section qv) 49 of the Eugene Code, 1971, and/or ORS . To wit, you: <br /> Po.SES' inAeiJi4rU) JAI P4 e* <br /> (Description of the violation.) <br /> This restriction of use is effective beginning on Def /'I, , and shall remain in effect until ei9 / . <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 /> • <br /> Pursuant to Park and Open Space Rule R- 1.074 you are entitled to an informal hearing to contest this Notice. 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 /> 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 daterran time shown above by: <br /> (Signature o person issuing /delivering notice) <br /> I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br /> ` „-•\ ' : " • AL , / U .a <br /> Signatur o person being issued the notice) <br /> White Copy: Public Works Green Copy: File Yellow Copy: Report Copy Pink Copy: Recipient Gold Copy: Officer Appeal notice Rev. 04/03 <br />