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NOTICE OF RESIRICTION OF USE <br />and Notice of Right to Appe al <br />DATE: TIME. CASE#: <br />LOCATION (PARKJOPEN SPACE) <br />h1s'�W�',c4M <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 arc prohibited from (check box): <br />Entering in or using all City of Eugene parks., open spaces or facilities. <br />0 <br />(Description of the violation.) <br />This restriction of use is effective beginning on and shall remain in effect until <br />I r 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 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 49 hours (exclusive of weekends) of receipt of this Notice. at the following address: 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />The Division Director shal I gehed u le a time and place for the informal hearing to be conducted, which shal I be not more th <br />7 2 It o urs I ex c lu s i v e o f weeke n d s F,, of ree e i xt of thr req u est foT h c arin_q—Aj1W--jmf 1 1, <br />consider testimony from you, City personnel involved in the incident that rcsulted in this Notice, and other witnesses to tj <br />incident, The Division Director may exclude anyone, other than you and those presenting testimony, from the informal hearin <br />'Fhis Notice shall rernain in effect pending any requested hearing. <br />This Notice of Exclusion was delivered to the person named at the top of this Notice the date and time shown above by: <br />Ig , ture (if person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time in <br />Whae Copy: PuWb Works Greun Copy! File YcHow Copy: Report Copy Pink Copy; k"ipient (3 ol d Uo pv . c ) ffi u u r A lip Lnt [ i wti c u Rev- (W03 <br />Narne Las! First Middle <br />DOB: <br />Race/Sex: <br />SLA Ire -t <br />re)("3115?) <br />1i <br />Res'. Address. city. <br />State <br />Zip <br />Res. Mone: <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 arc prohibited from (check box): <br />Entering in or using all City of Eugene parks., open spaces or facilities. <br />0 <br />(Description of the violation.) <br />This restriction of use is effective beginning on and shall remain in effect until <br />I r 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 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 49 hours (exclusive of weekends) of receipt of this Notice. at the following address: 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />The Division Director shal I gehed u le a time and place for the informal hearing to be conducted, which shal I be not more th <br />7 2 It o urs I ex c lu s i v e o f weeke n d s F,, of ree e i xt of thr req u est foT h c arin_q—Aj1W--jmf 1 1, <br />consider testimony from you, City personnel involved in the incident that rcsulted in this Notice, and other witnesses to tj <br />incident, The Division Director may exclude anyone, other than you and those presenting testimony, from the informal hearin <br />'Fhis Notice shall rernain in effect pending any requested hearing. <br />This Notice of Exclusion was delivered to the person named at the top of this Notice the date and time shown above by: <br />Ig , ture (if person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time in <br />Whae Copy: PuWb Works Greun Copy! File YcHow Copy: Report Copy Pink Copy; k"ipient (3 ol d Uo pv . c ) ffi u u r A lip Lnt [ i wti c u Rev- (W03 <br />