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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 />EAtering in or using all City of Eugene ar s, open spaces or facilities. <br />U <br />The basis for this Notice of Restriction of Use is that on 10-0 — 11 <br />you violated Section of the Park <br />and Open Space Rules, and/or Section of the 1 Code, 1971, and/or OR 'ro wit, you: <br />(Description ofthe violation.) <br />This restriction of use is effective beginning on <br />and shall remain in effect until <br />0 4 <br />If you enter in or case any City of Eugene park, open Space Or filCifity during the effective period of" this Notice, you may" be <br />,Arrested and char with crin trespass in the second degree. <br />Purcmant to Park and Open Space Rule If- 1.074 you are entitled to an informal hearing to contest this Notice. A request fi-ir an <br />infiormal hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />within 48 hours (excl usive of weekends) of receipt ofthis Notice at the following address: 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />The Division Director shall schedule a time and place lor the infornial hearing to be conducted, which shall be not more than <br />7/21 hours (exclusive of'weekcnds) ofreceipt of the request for hearmg_ At the infornud hearing the Division Director will only <br />consider testimony fi - om you, City personnel involved in the incident that resulted in this Notice, and other witnesses to the <br />incident, 1"he Division Director may exclude anyone, other than you and those presenting tcws firnony, 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 this Notice a, e date ait 'time shown above by: <br />ignaft.ffe 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 />White Copy P01 �c Wm ks 61 1 [e Ydfow ( opy: Rcpoit Copy Pmk Copy: Recipient GAI ( opy: 01ficer Appefl nonce Pe v 04 03 <br />Maine: Last First Mi <br />ID, <br />DOB <br />�Ij <br />q A (it d "i City <br />St t Zip <br />1�es, Mime: <br />Work Phone: <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 />EAtering in or using all City of Eugene ar s, open spaces or facilities. <br />U <br />The basis for this Notice of Restriction of Use is that on 10-0 — 11 <br />you violated Section of the Park <br />and Open Space Rules, and/or Section of the 1 Code, 1971, and/or OR 'ro wit, you: <br />(Description ofthe violation.) <br />This restriction of use is effective beginning on <br />and shall remain in effect until <br />0 4 <br />If you enter in or case any City of Eugene park, open Space Or filCifity during the effective period of" this Notice, you may" be <br />,Arrested and char with crin trespass in the second degree. <br />Purcmant to Park and Open Space Rule If- 1.074 you are entitled to an informal hearing to contest this Notice. A request fi-ir an <br />infiormal hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />within 48 hours (excl usive of weekends) of receipt ofthis Notice at the following address: 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />The Division Director shall schedule a time and place lor the infornial hearing to be conducted, which shall be not more than <br />7/21 hours (exclusive of'weekcnds) ofreceipt of the request for hearmg_ At the infornud hearing the Division Director will only <br />consider testimony fi - om you, City personnel involved in the incident that resulted in this Notice, and other witnesses to the <br />incident, 1"he Division Director may exclude anyone, other than you and those presenting tcws firnony, 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 this Notice a, e date ait 'time shown above by: <br />ignaft.ffe 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 />White Copy P01 �c Wm ks 61 1 [e Ydfow ( opy: Rcpoit Copy Pmk Copy: Recipient GAI ( opy: 01ficer Appefl nonce Pe v 04 03 <br />