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XNk <br />/y i � lI( <br />U'nder 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 (cheek box): <br />a <br />The basis for this Notice of Restriction of Uw is that on you violated Section / I of the Park <br />acid Open S pace Bastes, and/or Sect] 01-1 of the E r r gene Code, 1971 and1or ORS To wft. you:_ <br />A <br />(Description of the violation.) <br />This restrietion of use is effective beginning on N / Ll and shall remain in effect until q <br />4d <br />If YOU enter in or use any City of Eugene park, open space or facility during the effect I %, c period ofthis Nodec, you may Inc. <br />arrested and charged with criminal trespass in the second degree. <br />Pursuant to Park and Open Space Rule ft -1.074 you are entitled to an inforaial hearing to contest this Notice. A request for if) <br />informal hearing Must be rnade in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />within 48 hours (exclusive of weekends) of receipt ofthis Notice at the foflovv inn addrcss: 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />The Division Director shall schedule time and place for the inforl hearing to be conducted, which shall be not more than <br />72 hours (CXClU1,JVCof weekends) of receipt of the reque for hearing, At the informal hearino 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 Ilre <br />incident. The Di vision Director may exclude anvone, other than YOU and those presenting testimony, frorn the informal hearing. <br />This Notice shall remain in effect pending any requested hearing. <br />This Notice ol'Exclusion was delivered to the person named at the top of this N <br />at the date and tirne shown above by:. <br />- e of person issuing/delivering notice) <br />0 <br />( hereby acknowledge receipt of the above Notice on the date and time in <br />above, <br />(Signature of person, being issued the notice) <br />Whi I c Cop) . Public Wojkti Glee nCopy: 1"A" ydlow C cjpy Repcjr@ Copy Pink (op) : Recipical Gull CoPy -- ffficer Appeal notico R u 0 4 V <br />1, C <br />Narne. Last fi rst !"vi'd t I <br />DOB: <br />Race/S <br />Res, Addres. <br />skate <br />Zip <br />Res, Phone: <br />Work Nione: <br />U'nder 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 (cheek box): <br />a <br />The basis for this Notice of Restriction of Uw is that on you violated Section / I of the Park <br />acid Open S pace Bastes, and/or Sect] 01-1 of the E r r gene Code, 1971 and1or ORS To wft. you:_ <br />A <br />(Description of the violation.) <br />This restrietion of use is effective beginning on N / Ll and shall remain in effect until q <br />4d <br />If YOU enter in or use any City of Eugene park, open space or facility during the effect I %, c period ofthis Nodec, you may Inc. <br />arrested and charged with criminal trespass in the second degree. <br />Pursuant to Park and Open Space Rule ft -1.074 you are entitled to an inforaial hearing to contest this Notice. A request for if) <br />informal hearing Must be rnade in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />within 48 hours (exclusive of weekends) of receipt ofthis Notice at the foflovv inn addrcss: 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />The Division Director shall schedule time and place for the inforl hearing to be conducted, which shall be not more than <br />72 hours (CXClU1,JVCof weekends) of receipt of the reque for hearing, At the informal hearino 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 Ilre <br />incident. The Di vision Director may exclude anvone, other than YOU and those presenting testimony, frorn the informal hearing. <br />This Notice shall remain in effect pending any requested hearing. <br />This Notice ol'Exclusion was delivered to the person named at the top of this N <br />at the date and tirne shown above by:. <br />- e of person issuing/delivering notice) <br />0 <br />( hereby acknowledge receipt of the above Notice on the date and time in <br />above, <br />(Signature of person, being issued the notice) <br />Whi I c Cop) . Public Wojkti Glee nCopy: 1"A" ydlow C cjpy Repcjr@ Copy Pink (op) : Recipical Gull CoPy -- ffficer Appeal notico R u 0 4 V <br />