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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 />a <br />(, Description of the violation. <br />This restriction of use is effective beginning on 5Uls //Li and shall remain in effect until <br />If you enter in or tree 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 intbrurial hearing to contest this Notice. Arequest forall <br />informal hearing must be made in writing and filed with the Parks & Open Space Division Director ("tire Division Director') <br />within 48 hours (exclusive of weekends) of receipt ofthis Notice at the following addre.w 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />The Division Director shall whedule a tirne and place for the informal hearing to be conducted, which shall be not more th <br />72 ho urs (exel usive o F weekends I of recei nt of the reX, ue-st for hea rin p. At the. informalka. I <br />-rin the Division Director will oni <br />consider testimony rrom you, City personnel involved in the incident that resulted in this Notice, and other witnesses to t <br />incident. The Division Director may exclude arillone other thanyou and those Froin the infor =A <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 oi'this Notice at the date and time shown above by: <br />(Signature ol'person iS`,4Hr1g/dCl1Verh1g t10tiCe) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above, <br />V <br />---------- 2?_0_EQ - <br />(Signature of person being issued the notice) <br />Wh i ic Cnp Pubi Work a OreenC%iy. File Yd1ow Copy: kcpu[t Copy Vink Cory: Riwipicnt (k4d Copy Officer App 7al ntAlce Rev, M03 <br />Nanie: La <br />Firq <br />Mi(WIC <br />DM <br />Race,'Sex: <br />fYL C_ C <br />t. <br />Res- Addrtss: <br />city <br />State <br />Zip <br />Re Phnne: <br />work Photle: <br />1 � <br />0 <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 />a <br />(, Description of the violation. <br />This restriction of use is effective beginning on 5Uls //Li and shall remain in effect until <br />If you enter in or tree 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 intbrurial hearing to contest this Notice. Arequest forall <br />informal hearing must be made in writing and filed with the Parks & Open Space Division Director ("tire Division Director') <br />within 48 hours (exclusive of weekends) of receipt ofthis Notice at the following addre.w 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />The Division Director shall whedule a tirne and place for the informal hearing to be conducted, which shall be not more th <br />72 ho urs (exel usive o F weekends I of recei nt of the reX, ue-st for hea rin p. At the. informalka. I <br />-rin the Division Director will oni <br />consider testimony rrom you, City personnel involved in the incident that resulted in this Notice, and other witnesses to t <br />incident. The Division Director may exclude arillone other thanyou and those Froin the infor =A <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 oi'this Notice at the date and time shown above by: <br />(Signature ol'person iS`,4Hr1g/dCl1Verh1g t10tiCe) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above, <br />V <br />---------- 2?_0_EQ - <br />(Signature of person being issued the notice) <br />Wh i ic Cnp Pubi Work a OreenC%iy. File Yd1ow Copy: kcpu[t Copy Vink Cory: Riwipicnt (k4d Copy Officer App 7al ntAlce Rev, M03 <br />