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NOTICE OF RESTRICTION OF USE c6 � q %V 4 5 <br />V <br />'z <br />­ <br />DATE. r <br />and Notice of Right to Appeal <br />TIME: C A S <br />LOCATION (PARK/OPE'N SPACE) <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 />A Entering in or using all City of Eugene parks, open spaces or facilities. <br />K <br />The basis for this Notice of Restriction of Use is that on you virlhated Section <br />and Open Space Rules, and;/or Section of the Eugene Code, 197 1 , , andl'or ORS <br />4" <br />(Description of the violation.) <br />To Wit, You: <br />M <br />This restriction of use is effective beginning on and shall remain in effect until <br />11"you enter in or use any City of Fugene park, open space or Iacility during the effective period of this Notice, you ioav 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 infori hearing to contest this Notice. A request for all <br />informal hearing rnust be rnade in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />within 48 hours (exclusive of'weehends) 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 testiniony frorn you, City personnel involved in the incident that resulted in this Notice, and other witnesses to tile <br />incident, The Division Director inav exclude anyone, other than you and those presenting testimony, from the in formal 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 [irne shown above by: <br />(Signature ofl,'.)erson issuing/delivering rmtice) <br />I hereby acknowledge receipt of the above Notice on the date arld lin'le indicated above, <br />(Signature of person being issued the ricaice) <br />WhjW Copy: Public Work Grekn[Copv File Yellow Cupv: Repoli Copy Pink ( q)y: Re,ipicnt Gwid Copy: Of1kcr AppcGi I nom;c I 6_-e 61: 0", <br />Name: qt First N-fiddle <br />DOW <br />Race 'ae" <br />241 <br />Re, Addresq City <br />State <br />Zip <br />Res Phoney <br />Work flhone� <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 />A Entering in or using all City of Eugene parks, open spaces or facilities. <br />K <br />The basis for this Notice of Restriction of Use is that on you virlhated Section <br />and Open Space Rules, and;/or Section of the Eugene Code, 197 1 , , andl'or ORS <br />4" <br />(Description of the violation.) <br />To Wit, You: <br />M <br />This restriction of use is effective beginning on and shall remain in effect until <br />11"you enter in or use any City of Fugene park, open space or Iacility during the effective period of this Notice, you ioav 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 infori hearing to contest this Notice. A request for all <br />informal hearing rnust be rnade in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />within 48 hours (exclusive of'weehends) 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 testiniony frorn you, City personnel involved in the incident that resulted in this Notice, and other witnesses to tile <br />incident, The Division Director inav exclude anyone, other than you and those presenting testimony, from the in formal 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 [irne shown above by: <br />(Signature ofl,'.)erson issuing/delivering rmtice) <br />I hereby acknowledge receipt of the above Notice on the date arld lin'le indicated above, <br />(Signature of person being issued the ricaice) <br />WhjW Copy: Public Work Grekn[Copv File Yellow Cupv: Repoli Copy Pink ( q)y: Re,ipicnt Gwid Copy: Of1kcr AppcGi I nom;c I 6_-e 61: 0", <br />