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NOTICE OF RESTRICTION OF USE
<br />and Notice of Right to Appeal
<br />5�,513zti�.
<br />DATF. YIME: CASF
<br />LOCATION (PARK.IleOPEN
<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 />0 Entering in or using all City of Eugene parks, open spaces or facilities.
<br />The basis for this Notice of'Restriction of Use is that on -10-04-1-4- ----- ------ ------ Y0uvk of the lark
<br />and Open Space Rules, and/or Section of the Eugene Code, 1 971, andJor ORS 1'o wit, you:
<br />M
<br />(Description of the violation.)
<br />IN
<br />z
<br />This restriction of use is effective beginning on 0-0—/ LL—, a nd shall remain in effect writ l /0
<br />If you enter in or rise any City of Eugene park, open space or facility (Wring the offlectivc 1)eriod of this Notice, you may be
<br />arrested and charged witil criminal trespass in the second degree,
<br />L�
<br />Pursuant to Park and Open Space Rule R-1.074 You are entitled to an infian hearing to contest this Notice. A reques.t for an
<br />infornial hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Director")
<br />within 4S haters (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 1'br the informal hearing to be conducted, which shall be not ruiore than
<br />72 hours (exclusive (A'weekends) of receipt of the request for hearing. At the informal hearing the Division Director will only
<br />consider testimony fro you., City Personnel involved in the incident that resulted in this Notice, and other witnesses to the
<br />incident, The Division Director rila y a one, other than you and those presenting testhrio g. ny, !turn the infiol hearin any
<br />This Notice shall remain in effect pending any requested hearing.
<br />This Notice, oJ'Fxclu was delivered to the person earned at the top of dlis�Noti at the date rand titne shown above by.
<br />n
<br />ture cif person issuing deliv eri rig notice)
<br />I hereby acknowledge receipt ofthe above Notice on the date and tirsac rcdatecl above.
<br />(Slgfi4ature of person be lTig iSSLIC(l the notice)
<br />WhAe C011y. N1111V WOE'Kv Gre-on ( opy: File YcHow Copy: Report Lopy Pink Cop Rmpieni GoM ( opy. OftkQ� Appo notice,
<br />Nan Lsist Fi t Middle
<br />DOB,
<br />Race,
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<br />Res, Address: Cm
<br />State
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<br />Work 4
<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 />0 Entering in or using all City of Eugene parks, open spaces or facilities.
<br />The basis for this Notice of'Restriction of Use is that on -10-04-1-4- ----- ------ ------ Y0uvk of the lark
<br />and Open Space Rules, and/or Section of the Eugene Code, 1 971, andJor ORS 1'o wit, you:
<br />M
<br />(Description of the violation.)
<br />IN
<br />z
<br />This restriction of use is effective beginning on 0-0—/ LL—, a nd shall remain in effect writ l /0
<br />If you enter in or rise any City of Eugene park, open space or facility (Wring the offlectivc 1)eriod of this Notice, you may be
<br />arrested and charged witil criminal trespass in the second degree,
<br />L�
<br />Pursuant to Park and Open Space Rule R-1.074 You are entitled to an infian hearing to contest this Notice. A reques.t for an
<br />infornial hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Director")
<br />within 4S haters (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 1'br the informal hearing to be conducted, which shall be not ruiore than
<br />72 hours (exclusive (A'weekends) of receipt of the request for hearing. At the informal hearing the Division Director will only
<br />consider testimony fro you., City Personnel involved in the incident that resulted in this Notice, and other witnesses to the
<br />incident, The Division Director rila y a one, other than you and those presenting testhrio g. ny, !turn the infiol hearin any
<br />This Notice shall remain in effect pending any requested hearing.
<br />This Notice, oJ'Fxclu was delivered to the person earned at the top of dlis�Noti at the date rand titne shown above by.
<br />n
<br />ture cif person issuing deliv eri rig notice)
<br />I hereby acknowledge receipt ofthe above Notice on the date and tirsac rcdatecl above.
<br />(Slgfi4ature of person be lTig iSSLIC(l the notice)
<br />WhAe C011y. N1111V WOE'Kv Gre-on ( opy: File YcHow Copy: Report Lopy Pink Cop Rmpieni GoM ( opy. OftkQ� Appo notice,
<br />
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