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IJnder the authority of Administrative Order No. 58-03-24-F a nd 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 />El <br />'Elie basis for this Notice of Restriction of Use is that on you violated Section _L—,VX � f tae <br />, ? PS <br />and Open Space Rules, and/or Seefionql -- oftlic Eugene Code, 197 1, and/or ORS To wit, You: i <br />arrested and changed with crin trespass in the second degree <br />Pursuant to Park and Open Space Rule f? - you are entitled to an informal hea.ring to contest this Notice. A reqUest for an <br />inforaial hearing must be made in writing iand filed with the Parks & Open Space Division Director $ "thc Division Director") <br />within 48 hours (exclusive of weekends) of receipt ofthis Notice at the following address: 1820 Roosevelt, Blvd., Eugene, OR <br />97402, <br />The Division Director shall schedule a time and place for the itil'ornial hearing to be conducted, which shall be not more than <br />72 hOLIrS (eXCIUSiVe of weekends) of receipt Of the 1 flor hearing, At the informal hearing the Division Director will orkly <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 inay exclude anyone, other than VOU and those presenting testimony, from the infornia] hearing, <br />This Notice shall remain in effect pending any requested hearing. <br />This Notice ot'Exclusion wag delivered to the person named at the top of this Notice at the (late and tiaie shown above by <br />(Signature of person issuing"'ifelivering notice) <br />I hereby acknowledge receipt of" the. above Notice on the date and time indicated above, <br />(Signature of'person being issued the notice) <br />Whig Nbl ic Wurks (1 Fik. Yel low UI qly Rt!pon Copy Nuk (opv: R(n cipmo Gold Coin, Oflk r Appeat no6ce R(e V- WiW <br />Na wa Lasa F i rs t MlMe <br />M3� <br />Race Sex <br />t Re!.Addrvss. Cit�v <br />siaLe <br />Zip <br />Res Phone: <br />Work Plx el <br />IJnder the authority of Administrative Order No. 58-03-24-F a nd 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 />El <br />'Elie basis for this Notice of Restriction of Use is that on you violated Section _L—,VX � f tae <br />, ? PS <br />and Open Space Rules, and/or Seefionql -- oftlic Eugene Code, 197 1, and/or ORS To wit, You: i <br />arrested and changed with crin trespass in the second degree <br />Pursuant to Park and Open Space Rule f? - you are entitled to an informal hea.ring to contest this Notice. A reqUest for an <br />inforaial hearing must be made in writing iand filed with the Parks & Open Space Division Director $ "thc Division Director") <br />within 48 hours (exclusive of weekends) of receipt ofthis Notice at the following address: 1820 Roosevelt, Blvd., Eugene, OR <br />97402, <br />The Division Director shall schedule a time and place for the itil'ornial hearing to be conducted, which shall be not more than <br />72 hOLIrS (eXCIUSiVe of weekends) of receipt Of the 1 flor hearing, At the informal hearing the Division Director will orkly <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 inay exclude anyone, other than VOU and those presenting testimony, from the infornia] hearing, <br />This Notice shall remain in effect pending any requested hearing. <br />This Notice ot'Exclusion wag delivered to the person named at the top of this Notice at the (late and tiaie shown above by <br />(Signature of person issuing"'ifelivering notice) <br />I hereby acknowledge receipt of" the. above Notice on the date and time indicated above, <br />(Signature of'person being issued the notice) <br />Whig Nbl ic Wurks (1 Fik. Yel low UI qly Rt!pon Copy Nuk (opv: R(n cipmo Gold Coin, Oflk r Appeat no6ce R(e V- WiW <br />