NOTICE OF RESTRICTION OF USE <br />and Notice cat' might to Appeal <br />TIME: A CASE4 <br />DATE -P <br />I C J <br />1-,OCA ,--- <br />Under the authority of Administrative Order No. 58-03-24-F and Park and Open Space Rule R- 1.005( ), you are hereby <br />notified that you are prohibited from (check box): <br />X 1 Entering in or using all City of Eugene parks, open spaces or facilities. <br />0 <br />Pursuant to Park and Open Space Rule R -1.074 VOU are entitled to art informal hearing to contest this Notice, A request f6r an <br />informal hearing must be triad e in writing and filed with the Parks clk Open Space Division Director (,"the Division Ditector") <br />within 48 hours (exclusive of weekends) of receipt of this Notice at the followingarldress: 1820 Roosevelt, Blvd, Eugene, OR <br />97402, <br />The Division Director shall schedule a tfine and place for the informal hearing to be conducted, which shall be not more than <br />72 hours (exclusive of'weekends) of receipt of the reqUeSt ft hearing. At the informal 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 t. his Notice a the at a nd tin -, sho wn above fey; ()tl— / - na'defivering n(.)tice) <br />S , <br />igna,4 re of p -son issul <br />I hereby acknowledge receipt ofthe above Notice on the date and time indicated above, <br />(Signature of person being iSSUed the riofice,) <br />Copy: Public Wuik UJl t ojli- He Y e I I o w 4 " 013Y R cpm 1 0 [Py Pink Uop Rccipical Gold Copy: ()Fficej'Appear 8484 Re%, 04 ,03 <br />Naine: Last First Micidle <br />. ...... <br />Dffli <br />--- r --------------- 7 <br />R es, Adt:d�res <br />Z111 <br />Res. Phone: <br />Re <br />Work Phone: <br />Under the authority of Administrative Order No. 58-03-24-F and Park and Open Space Rule R- 1.005( ), you are hereby <br />notified that you are prohibited from (check box): <br />X 1 Entering in or using all City of Eugene parks, open spaces or facilities. <br />0 <br />Pursuant to Park and Open Space Rule R -1.074 VOU are entitled to art informal hearing to contest this Notice, A request f6r an <br />informal hearing must be triad e in writing and filed with the Parks clk Open Space Division Director (,"the Division Ditector") <br />within 48 hours (exclusive of weekends) of receipt of this Notice at the followingarldress: 1820 Roosevelt, Blvd, Eugene, OR <br />97402, <br />The Division Director shall schedule a tfine and place for the informal hearing to be conducted, which shall be not more than <br />72 hours (exclusive of'weekends) of receipt of the reqUeSt ft hearing. At the informal 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 t. his Notice a the at a nd tin -, sho wn above fey; ()tl— / - na'defivering n(.)tice) <br />S , <br />igna,4 re of p -son issul <br />I hereby acknowledge receipt ofthe above Notice on the date and time indicated above, <br />(Signature of person being iSSUed the riofice,) <br />Copy: Public Wuik UJl t ojli- He Y e I I o w 4 " 013Y R cpm 1 0 [Py Pink Uop Rccipical Gold Copy: ()Fficej'Appear 8484 Re%, 04 ,03 <br />