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Under the authority olAdministrative Order No. 58-03-24 -Fan d 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 />7 <br />I <br />The basis f , you vioWed e <br />or this Notic e of" Restr c l on of Use is th at on , — 7-" " - A <br />Section Park <br />and Open Space Rules, andf'or Section cwfthe Eugene Code, 1971, and /or OR To wit, you: <br />(Description of the violation.) <br />t?_ <br />lf'y(.)Lj enter in or use any C ly ofEugene park. open space or f during the effective period of this Notice, you rue, b <br />- 1 - y e <br />arrested and charged with crin trespass in the second degree. <br />Pursuant to Park and Open Space Rule R-1.074 you are entitled to an informal hearing to contest this Notice. A request for art <br />informal hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Director") <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 more then <br />72 1101.IrS (CXClLVSiVC of weekends) of receipt of the request for hearing. At the informal hearing the Division Director will only <br />consider testimony fixnn you, (,,'uy personnel involved in the incident that resulted in this Notice, and other winicsw's to the <br />incident. The Division Director may cxclude anyone, other than von 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 earned at the lop of this Notice at the date and time shown abovc by: <br />(Signature of person issuing/deliverina notice') <br />I hereby acknowledge receipt of the above Notice on the date and thee: indicated above. <br />(Signature ot'person being issued the notice) <br />1 hmc Copy PuH iu 44 oi k, Gro-nCopy: Filu YsIkjvv Copy: R�pmt ( opy Pink Copy: Recipicni (iold ( ojpy_ Offlicei Appeal notice L 1 94 1 C[± <br />Nztrne Last First Middle D(ft C X <br />z q r� " <br />Res. Address: City State zip Res, More: Work Phone: <br />2 <br />Under the authority olAdministrative Order No. 58-03-24 -Fan d 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 />7 <br />I <br />The basis f , you vioWed e <br />or this Notic e of" Restr c l on of Use is th at on , — 7-" " - A <br />Section Park <br />and Open Space Rules, andf'or Section cwfthe Eugene Code, 1971, and /or OR To wit, you: <br />(Description of the violation.) <br />t?_ <br />lf'y(.)Lj enter in or use any C ly ofEugene park. open space or f during the effective period of this Notice, you rue, b <br />- 1 - y e <br />arrested and charged with crin trespass in the second degree. <br />Pursuant to Park and Open Space Rule R-1.074 you are entitled to an informal hearing to contest this Notice. A request for art <br />informal hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Director") <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 more then <br />72 1101.IrS (CXClLVSiVC of weekends) of receipt of the request for hearing. At the informal hearing the Division Director will only <br />consider testimony fixnn you, (,,'uy personnel involved in the incident that resulted in this Notice, and other winicsw's to the <br />incident. The Division Director may cxclude anyone, other than von 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 earned at the lop of this Notice at the date and time shown abovc by: <br />(Signature of person issuing/deliverina notice') <br />I hereby acknowledge receipt of the above Notice on the date and thee: indicated above. <br />(Signature ot'person being issued the notice) <br />1 hmc Copy PuH iu 44 oi k, Gro-nCopy: Filu YsIkjvv Copy: R�pmt ( opy Pink Copy: Recipicni (iold ( ojpy_ Offlicei Appeal notice L 1 94 1 C[± <br />