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NOTICE OF RESTRICTION OF USE
<br />and Notice of'Right to Appeal
<br />DATE: TIME: CASE ft
<br />LOCATION (PARK./OPEN SPACE):_A 511 - - - - - - -
<br />Under the authority of Adrninistrative Order No. 58-03-24-F and Park and Open Space Rule 114.005(3), you acre hereby
<br />notified that you are prohibited from (check box):
<br />Entering in or using all City of Eugene parks, open spaces or facilities.
<br />0
<br />The basis for this Notice of Restriction ofLJJsc is that on VOU violated Section /t
<br />1 '05?� ofthe Park
<br />Open Space Rule and/or Section ---, — --- ---- of the Eugene Code, 1 971, and./or ORS TO Wit, YOU:
<br />o (,- A-V :r- 0 )- &
<br />(Description of the violation,)
<br />This restriction of use is effective beginning on and shall rernain in effect unfil
<br />If vou enter in or use any City. of Eugene park, open space or tacifity during the cffective period of this 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 ] I'01 cil
<br />informal hearing MUst be rnade in writing and tiled with the Parks & Open Space Division Director ("the Division Director")
<br />within 48 hours (excusive of weekends) of receipt of this Notice at the following address 1820 Roosevelt, Blvd., Eugene, OR
<br />97401
<br />The Division Director shall schedule as time and place for the informal hearing to be conducted, which shall be not itiore (Nan
<br />72 h0Lu (exclusive o1'wcekend of'reccipt of the request flor hearing. At the inficirmal hearing the Division Director wi H only
<br />consider tcstjinonv thorn you, City personnel involved in the incident that resulted in this Notice, and other witnesses. to the
<br />incident. The Division Director rnay exclude anyone, other than you and those presenting testimony, from [lie infornial hearing,
<br />This Notice shall remain in effect pending any requested hearing.
<br />t, "
<br />This Notice of Exclusion was delivered to the person na-med at the top of this Not' at the date and finie shown above by:
<br />1--�
<br />(Signa ire ol'person issuing/delivering notice)
<br />I hereby acknowledge receipt of the above Notice on the date and time indicated above.
<br />#
<br />(Signature of person being issued the notice)
<br />Mike ( opy: 'ubli�: Woi ks Ocun ( opy: File Yellow Copy Rcpun Cop) Pink Cop�: Recijpicn Gi &f Co 0 �'fi, c r .gyp c, E I i i o (i c c Pwv 0410i
<br />r l klicldJe
<br />D013:
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<br />Res Ad(lress: Cily
<br />--- ,X
<br />State
<br />Zip
<br />Re"- Phone�
<br />Work PKIlile:
<br />0*j S
<br />Under the authority of Adrninistrative Order No. 58-03-24-F and Park and Open Space Rule 114.005(3), you acre hereby
<br />notified that you are prohibited from (check box):
<br />Entering in or using all City of Eugene parks, open spaces or facilities.
<br />0
<br />The basis for this Notice of Restriction ofLJJsc is that on VOU violated Section /t
<br />1 '05?� ofthe Park
<br />Open Space Rule and/or Section ---, — --- ---- of the Eugene Code, 1 971, and./or ORS TO Wit, YOU:
<br />o (,- A-V :r- 0 )- &
<br />(Description of the violation,)
<br />This restriction of use is effective beginning on and shall rernain in effect unfil
<br />If vou enter in or use any City. of Eugene park, open space or tacifity during the cffective period of this 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 ] I'01 cil
<br />informal hearing MUst be rnade in writing and tiled with the Parks & Open Space Division Director ("the Division Director")
<br />within 48 hours (excusive of weekends) of receipt of this Notice at the following address 1820 Roosevelt, Blvd., Eugene, OR
<br />97401
<br />The Division Director shall schedule as time and place for the informal hearing to be conducted, which shall be not itiore (Nan
<br />72 h0Lu (exclusive o1'wcekend of'reccipt of the request flor hearing. At the inficirmal hearing the Division Director wi H only
<br />consider tcstjinonv thorn you, City personnel involved in the incident that resulted in this Notice, and other witnesses. to the
<br />incident. The Division Director rnay exclude anyone, other than you and those presenting testimony, from [lie infornial hearing,
<br />This Notice shall remain in effect pending any requested hearing.
<br />t, "
<br />This Notice of Exclusion was delivered to the person na-med at the top of this Not' at the date and finie shown above by:
<br />1--�
<br />(Signa ire ol'person issuing/delivering notice)
<br />I hereby acknowledge receipt of the above Notice on the date and time indicated above.
<br />#
<br />(Signature of person being issued the notice)
<br />Mike ( opy: 'ubli�: Woi ks Ocun ( opy: File Yellow Copy Rcpun Cop) Pink Cop�: Recijpicn Gi &f Co 0 �'fi, c r .gyp c, E I i i o (i c c Pwv 0410i
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