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NOTICE OF RESTRICTION OF USE
<br />and Notice of Right to Appeal
<br />DATE: TIME:
<br />CASE, 4
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<br />LOCATION (PARK/OPEN SPACE):,___ C-J 0 817WAk GA �
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<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 />Entering in or using all City of Eugene parks, open spaces or facilities.
<br />I basis for this Notice of Restriction of" Use is that on t Oj I you violated Section the Park
<br />and Open Space Rules, and/or Section �J. of the Eugene Code, 197 1, and/or ORS To wit, you
<br />A
<br />=o:l 1L 11 1
<br />(Description of the violation.)
<br />This restriction of use is effective beginning on 10 1-� and shall remain in effect until I I
<br />If you enter in 01' Use any City of Eugene park-, open space or facility during the effective period of this Notice, You may be
<br />arrested and charged with crinrinal trespass in the second degree.
<br />L,
<br />Pursuant to Park and Open Space RUIC R-1.074 you are entitled to an inforinal hearing to contest this Notice, A request for an
<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 addre 1820 Roosevelt, Blvd., Eugene, OR
<br />97402a
<br />The Division Director shall schedule as time and place 6or the irdorrnal hearing to be con(ILIOCC1, which shall be not more than
<br />72 hours (exclusive of weekends) of receipt of the request fear he,'Iring. At the inforn hearing the Division Director will only
<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 may exclude anyone, other than you 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 named at the top of ibis Notice, 1 date arid little shown above by:
<br />("KignatUre of person issuing ,"dehvering notice' )
<br />I liereby acknowledge receipt of the above Notice on the date and tirric indicated above.
<br />(Signature cif perscai being issued the notice)
<br />lX hau ( opy: Public Woiks 61"Tj Copy Vik. YA,)w Copy: Repor� Copy Phil, Copy: Rcciplelll Gohl Copy, Offiii:cr Appc a nunjce Rn 04!03
<br />Naine: Lasicfwww, 11- I i r S t Middle
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<br />City
<br />Req. Addre�,& City
<br />slate 7,
<br />Zip
<br />Re Phone:
<br />Work 1
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<br />,A
<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 />Entering in or using all City of Eugene parks, open spaces or facilities.
<br />I basis for this Notice of Restriction of" Use is that on t Oj I you violated Section the Park
<br />and Open Space Rules, and/or Section �J. of the Eugene Code, 197 1, and/or ORS To wit, you
<br />A
<br />=o:l 1L 11 1
<br />(Description of the violation.)
<br />This restriction of use is effective beginning on 10 1-� and shall remain in effect until I I
<br />If you enter in 01' Use any City of Eugene park-, open space or facility during the effective period of this Notice, You may be
<br />arrested and charged with crinrinal trespass in the second degree.
<br />L,
<br />Pursuant to Park and Open Space RUIC R-1.074 you are entitled to an inforinal hearing to contest this Notice, A request for an
<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 addre 1820 Roosevelt, Blvd., Eugene, OR
<br />97402a
<br />The Division Director shall schedule as time and place 6or the irdorrnal hearing to be con(ILIOCC1, which shall be not more than
<br />72 hours (exclusive of weekends) of receipt of the request fear he,'Iring. At the inforn hearing the Division Director will only
<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 may exclude anyone, other than you 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 named at the top of ibis Notice, 1 date arid little shown above by:
<br />("KignatUre of person issuing ,"dehvering notice' )
<br />I liereby acknowledge receipt of the above Notice on the date and tirric indicated above.
<br />(Signature cif perscai being issued the notice)
<br />lX hau ( opy: Public Woiks 61"Tj Copy Vik. YA,)w Copy: Repor� Copy Phil, Copy: Rcciplelll Gohl Copy, Offiii:cr Appc a nunjce Rn 04!03
<br />
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