NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />DATE: TIME! 0 __ ---- <br />LOCATION (PARK/cOPFN SPACE): <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 />PC — 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 you violated Section of the Park <br />and Open Space Rules, and/or Sectiotl <br />ME <br />of the Eugene Code, 1971, andicar OR <br />15f7le- ye>74' <br />"r wit you: <br />(Description ofthe violation.) <br />This restriction of use is effective beginning on p q -main in effect untilpjq/ <br />and shall rc <br />If you enter In or use any City ofFugene park, open space or facility during the effective period ofthis Notice, you may be <br />arrested and charged with criminal trespass in the second degree. <br />Pursuant to Park and Open Space Rule R-1,074 you are entitled to an informal 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 address: 1820 lZoosevelt, Blvd., Eugene, Oil <br />97402. <br />The Division Director shall schedule as unic and place for the informal hearing to be conducted, which shall be not more than <br />1� <br />72 hours (cxc1u of'weckends) of'receipt of the request for hearing. At the informal hearing ' D <br />the ivision Direcor t will only <br />consider testimony fro You, ()ty personnel involve(] in the incident that resulted in this Notice, and other witnesses to the <br />incident, The Division Director may cxcludeanyone, other than you and those presenting testimony, from the inform al hearing. <br />This Notice shall remain in effect pending any requested hearing. C__ <br />This Notice of Exclusion was delivered to the person narned at the top of this N <br />z <br />vering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicath4,e6ove, <br />cin, <br />i g issued the notice) <br />i � n j W ir , 0 f - r & SO wl <br />Wlwc Cupy: Nblic Wwk, Gnxn(.opy� fitc yd4)s Copy RaP vrl ("'opy Pink Copy Recipient Gold (opy_ Oflker Ajppi�, mn4:4 RL"", 0 <br />rat the date and time shown above 1)y: <br />Naa LU MiddI4 <br />T r7, <br />DOB: <br />c/ "S V <br />Rae <br />�! I � _ - <br />W <br />C4 <br />[des. 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Phone <br />R e <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 />PC — 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 you violated Section of the Park <br />and Open Space Rules, and/or Sectiotl <br />ME <br />of the Eugene Code, 1971, andicar OR <br />15f7le- ye>74' <br />"r wit you: <br />(Description ofthe violation.) <br />This restriction of use is effective beginning on p q -main in effect untilpjq/ <br />and shall rc <br />If you enter In or use any City ofFugene park, open space or facility during the effective period ofthis Notice, you may be <br />arrested and charged with criminal trespass in the second degree. <br />Pursuant to Park and Open Space Rule R-1,074 you are entitled to an informal 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 address: 1820 lZoosevelt, Blvd., Eugene, Oil <br />97402. <br />The Division Director shall schedule as unic and place for the informal hearing to be conducted, which shall be not more than <br />1� <br />72 hours (cxc1u of'weckends) of'receipt of the request for hearing. At the informal hearing ' D <br />the ivision Direcor t will only <br />consider testimony fro You, ()ty personnel involve(] in the incident that resulted in this Notice, and other witnesses to the <br />incident, The Division Director may cxcludeanyone, other than you and those presenting testimony, from the inform al hearing. <br />This Notice shall remain in effect pending any requested hearing. C__ <br />This Notice of Exclusion was delivered to the person narned at the top of this N <br />z <br />vering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicath4,e6ove, <br />cin, <br />i g issued the notice) <br />i � n j W ir , 0 f - r & SO wl <br />Wlwc Cupy: Nblic Wwk, Gnxn(.opy� fitc yd4)s Copy RaP vrl ("'opy Pink Copy Recipient Gold (opy_ Oflker Ajppi�, mn4:4 RL"", 0 <br />rat the date and time shown above 1)y: <br />