NOTICE OTIZESTRICTION OF USE <br />and Notice of Right to Appeal <br />CASE 4 <br />DAT E: TIME: <br />LOCATION (PARK/OPEN SPACE): &�D <br />U nder the authority ofAdnd nistrative Order No. 58-03-24-F an d Park acrd O pen Space Kale R- 1.005(3), you a re lie reby <br />notified that you are prohibited from (check box): <br />Entering in or using till City of Eugene parks, open spaces or facilities. <br />y <br />The basis for this Notice ol " Restriction ofUse is that on 0 <br />YOU violated Section ofthe Park <br />and Open Space Rules, and/or Section _411-90-- of the F ugene Code, 197 L andJor ORS TO wit, vole: <br />�` AJ <br />(Description of the viohation,) <br />This restriction or use is effective beginning on and shall remain in effect until <br />0:: <br />[f you enter in or use any Cily of Eugene park, open space or facility chirinc the effeed ve 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 RuIc R - you are entitled to an informal hearing to contest this Notice, A request for an <br />infornial hearin a must be made in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />within 48 hours (exclusive ofweekends); of receipt ol'this Notice at the t address: 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />The Division Director shat [ schedule a time and place for the informal licaring to be condLiCted, Which shall be not more than <br />72 hours (exclusive cif' weekends) of receipt of the request Im hearing. At the informal hearing the Div ision Director will only <br />consider testimony 1roni 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 date and flaie shown above bvi <br />(Signature of person issunqy delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and lu indicalerlabove. <br />(Signature ol'person being issued the notice) <br />Whj€e Copy Public oi ks O(Ttl(opy: File yellokk Copy Repo] L Colly NIA Copy Rcopicni Guld Copy: Offker Aj-qv it rotic( e <br />Nan)e: fkl tddlc <br />[)011: <br />Race /Se <br />N A N, <br />L3 <br />Cily <br />Res, Ad(lrcss� ty <br />7-1 P <br />Re Phone: <br />Work Phone: <br />R <br />U nder the authority ofAdnd nistrative Order No. 58-03-24-F an d Park acrd O pen Space Kale R- 1.005(3), you a re lie reby <br />notified that you are prohibited from (check box): <br />Entering in or using till City of Eugene parks, open spaces or facilities. <br />y <br />The basis for this Notice ol " Restriction ofUse is that on 0 <br />YOU violated Section ofthe Park <br />and Open Space Rules, and/or Section _411-90-- of the F ugene Code, 197 L andJor ORS TO wit, vole: <br />�` AJ <br />(Description of the viohation,) <br />This restriction or use is effective beginning on and shall remain in effect until <br />0:: <br />[f you enter in or use any Cily of Eugene park, open space or facility chirinc the effeed ve 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 RuIc R - you are entitled to an informal hearing to contest this Notice, A request for an <br />infornial hearin a must be made in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />within 48 hours (exclusive ofweekends); of receipt ol'this Notice at the t address: 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />The Division Director shat [ schedule a time and place for the informal licaring to be condLiCted, Which shall be not more than <br />72 hours (exclusive cif' weekends) of receipt of the request Im hearing. At the informal hearing the Div ision Director will only <br />consider testimony 1roni 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 date and flaie shown above bvi <br />(Signature of person issunqy delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and lu indicalerlabove. <br />(Signature ol'person being issued the notice) <br />Whj€e Copy Public oi ks O(Ttl(opy: File yellokk Copy Repo] L Colly NIA Copy Rcopicni Guld Copy: Offker Aj-qv it rotic( e <br />