New Search
LOCATION (PARK,"OPEN SPACE):_W_4V -, <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 proldbited from (cheek box)* <br />Entering in or using all City of Eugene parks, open spaces or facilities. <br />X <br />The Division Director shall schedule a time and place for the informal hearing to be conducted, which shall be not more than <br />72 hours (exclusive of weekends) of receipt oftfie request for 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 'N[otice, and other witnesses to the <br />incident, The Division Director may exclude anyone, other than you and those presenting testimony, ftorn the informal hearing. <br />`Uhis Notice shall remain in effect pending any requested hearing. <br />This Notice cif Exclusion was delivered to the person nained at the top ofthis Notice a I d e and litri e shown above by <br />(SignatUre ail person issning/deli�ermg notice) <br />I hereby, icknowledge receipt of the above Notice on the date and time indicated above, <br />(Signature Uperson being issued the notice) <br />Wlu�c Copy: Publw Work, Oem ( opy: 1 i[e Ydlow Copyi Rcpork Copy N4 Copy Recipicill (icfld Copy Qffivci App,.ul uw6ce R,: % - 04,403 , <br />Nanic: Last First Middle <br />DOB� <br />RaCe'S/ <br />Res- Address: City State <br />Zip <br />Res. Phone: <br />Work Phorw� <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 proldbited from (cheek box)* <br />Entering in or using all City of Eugene parks, open spaces or facilities. <br />X <br />The Division Director shall schedule a time and place for the informal hearing to be conducted, which shall be not more than <br />72 hours (exclusive of weekends) of receipt oftfie request for 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 'N[otice, and other witnesses to the <br />incident, The Division Director may exclude anyone, other than you and those presenting testimony, ftorn the informal hearing. <br />`Uhis Notice shall remain in effect pending any requested hearing. <br />This Notice cif Exclusion was delivered to the person nained at the top ofthis Notice a I d e and litri e shown above by <br />(SignatUre ail person issning/deli�ermg notice) <br />I hereby, icknowledge receipt of the above Notice on the date and time indicated above, <br />(Signature Uperson being issued the notice) <br />Wlu�c Copy: Publw Work, Oem ( opy: 1 i[e Ydlow Copyi Rcpork Copy N4 Copy Recipicill (icfld Copy Qffivci App,.ul uw6ce R,: % - 04,403 , <br />