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NOTICE OF RESTMCTION OF USE <br />and Notice of Right to Appeal <br />DA'11- FIME C, AS E TI: <br />LOCATION (PARK OPEN SPACF): <br />W pzs6c �f — <br />�A-? <br />G� 6'� Q <br />Under the authority of Administrative Order No. 58-03-24-Fand Park and Open Space Rule R-1.005(3), you are hereby <br />notified that vou are prohibited from (check. box): <br />Entering in or using all City of Eugene parks, open spaces or facilities. <br />0 <br />The basis for this Notice of Restriction of Use is that on Y� % you violated Section )�")N� f the Park <br />and Open Space Rules, and/or Section of the Eugene Code, 1971, , and/or ORS 1`0 wit, YOLI: <br />(Description of the violation.) <br />'this restriction of use is effiTtive begin n i ing on 6CVS and shall remain in effect until <br />If yen enter in or use any City of Eugene park, operi space or facility during the effective period of this Notice, you may be <br />arrested and charged with crianylal trespass in the second degree. <br />Pursuant to Park and Open Space Rule R- 1.074 you are entitled to an informal hearino to contest this Notice. A request for ar[ <br />I C <br />informal hearing must be made ]it writing and filed with the parks & Open Space Division Director ("the Division Direefor") <br />within 48 hours (exclusive of weekends) 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 11 than <br />72 h0Urs (exclusive of weekends) of receipt of the request for hearing. At the in Formal hearing the Division Director will only <br />consider testimony frorn 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 testirnorry, firom the informal hearing- <br />This Notice shall remain in effect pending any requested hearing. <br />This Notice ol'Exclusion was delivered to the person name(] at the top of this Notice at the date and tirne shown above ley� <br />vzl C r. <br />(Signature of'person issuing/delivering 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 />Wh c Copy Public Work, Ghcea(',,pv File Yenow ( opyl Repm ( opy Pink Copy: R"ipicm Gold Copy: OfI Appecl wtice Rev tWW <br />MidMe <br />DOB <br />Race /S <br />fees r d ress: c' - 1 ty <br />S <br />e� Res- Phoney <br />Work Plione: <br />-ST- � <br />Under the authority of Administrative Order No. 58-03-24-Fand Park and Open Space Rule R-1.005(3), you are hereby <br />notified that vou are prohibited from (check. box): <br />Entering in or using all City of Eugene parks, open spaces or facilities. <br />0 <br />The basis for this Notice of Restriction of Use is that on Y� % you violated Section )�")N� f the Park <br />and Open Space Rules, and/or Section of the Eugene Code, 1971, , and/or ORS 1`0 wit, YOLI: <br />(Description of the violation.) <br />'this restriction of use is effiTtive begin n i ing on 6CVS and shall remain in effect until <br />If yen enter in or use any City of Eugene park, operi space or facility during the effective period of this Notice, you may be <br />arrested and charged with crianylal trespass in the second degree. <br />Pursuant to Park and Open Space Rule R- 1.074 you are entitled to an informal hearino to contest this Notice. A request for ar[ <br />I C <br />informal hearing must be made ]it writing and filed with the parks & Open Space Division Director ("the Division Direefor") <br />within 48 hours (exclusive of weekends) 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 11 than <br />72 h0Urs (exclusive of weekends) of receipt of the request for hearing. At the in Formal hearing the Division Director will only <br />consider testimony frorn 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 testirnorry, firom the informal hearing- <br />This Notice shall remain in effect pending any requested hearing. <br />This Notice ol'Exclusion was delivered to the person name(] at the top of this Notice at the date and tirne shown above ley� <br />vzl C r. <br />(Signature of'person issuing/delivering 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 />Wh c Copy Public Work, Ghcea(',,pv File Yenow ( opyl Repm ( opy Pink Copy: R"ipicm Gold Copy: OfI Appecl wtice Rev tWW <br />