Under the a uthoritv of Administrative Order No. 58-03-24-F and Park and Open Space Rule R-1.00:5(3), you are hereby <br />notified that you tire prohibited from (check box). <br />W Entering in or using all City of Eugene parks, open spaces or facilities. <br />M <br />The basis for this Notice of Restriction of Use is that can on Ol V�Oofflie Park <br />you violated Secti <br />and Open Space Rules, and"or Section of the Eugene Code, 1971, and/or ORS To wit, you:_ <br />�,vlljllt jv <br />(Description of the violation.) <br />I'his restriction of use is effective beginning on and shall remain in effect until <br />Ifyou enter in or use any City oil' Eugene park, open space of I'acifity during the effective period of this Notice, you rnay be <br />arrested and charged with critnintil trespass in the second degree, <br />Pursuant IoPark and Open Space Rule R- 1.074) VOLT are entitled tea an informal hearing to cornesithis Notice, Arequestf6ran <br />informal hearing inust be made in writing and filed with the Parks & Open Space Division Director ( Division Director"g <br />within 48 hours (CXC]LV,iVe Of Weekends) of receipt of this Notice at the following address: 1820 Roosevelt, Blvd.. Eut, OR <br />97402. <br />The Division Director shall schedUIC as time and place for the informal hearing to be conducted, which shall be not more than <br />72 hours $exclusivc of'weekends) of receipt of the reqLIC4St for hearing, At the informal hearing the Division Director will only <br />consider testirriony from VOLL, 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, frorn the informal hearing, <br />This Notice shall remain in effect pending any requested hearing. <br />This Notice ot'Exclusion was delivered to the person named at the top of this Notice Lit the clate and firne shown above by: <br />r <br />(Signature ol'person issuing/dclivering nouce) <br />I hereby acknowledge receipt ofthe above Notice on the date and linic indicated above, <br />4 1 <br />(Signature of person being issued the rionce) <br />Wfiitc ('01)V: PLIMC W(9ate (ireen opy: Fil" 4 Mkm C opy R�pml Copy Pink top lkecpent fk)ld Cop : Offii,xr Appe�d jionce Rou"', 44 1)31 <br />Nanie Last First %iii(I(JIq <br />O!'J' <br />D013 <br />C3* <br />Rae sex. <br />P, es. Mdres� g Ciiv St Zip <br />cl� C 14 4 ' <br />lies, Phone: <br />z <br />Work Phone: <br />Under the a uthoritv of Administrative Order No. 58-03-24-F and Park and Open Space Rule R-1.00:5(3), you are hereby <br />notified that you tire prohibited from (check box). <br />W Entering in or using all City of Eugene parks, open spaces or facilities. <br />M <br />The basis for this Notice of Restriction of Use is that can on Ol V�Oofflie Park <br />you violated Secti <br />and Open Space Rules, and"or Section of the Eugene Code, 1971, and/or ORS To wit, you:_ <br />�,vlljllt jv <br />(Description of the violation.) <br />I'his restriction of use is effective beginning on and shall remain in effect until <br />Ifyou enter in or use any City oil' Eugene park, open space of I'acifity during the effective period of this Notice, you rnay be <br />arrested and charged with critnintil trespass in the second degree, <br />Pursuant IoPark and Open Space Rule R- 1.074) VOLT are entitled tea an informal hearing to cornesithis Notice, Arequestf6ran <br />informal hearing inust be made in writing and filed with the Parks & Open Space Division Director ( Division Director"g <br />within 48 hours (CXC]LV,iVe Of Weekends) of receipt of this Notice at the following address: 1820 Roosevelt, Blvd.. Eut, OR <br />97402. <br />The Division Director shall schedUIC as time and place for the informal hearing to be conducted, which shall be not more than <br />72 hours $exclusivc of'weekends) of receipt of the reqLIC4St for hearing, At the informal hearing the Division Director will only <br />consider testirriony from VOLL, 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, frorn the informal hearing, <br />This Notice shall remain in effect pending any requested hearing. <br />This Notice ot'Exclusion was delivered to the person named at the top of this Notice Lit the clate and firne shown above by: <br />r <br />(Signature ol'person issuing/dclivering nouce) <br />I hereby acknowledge receipt ofthe above Notice on the date and linic indicated above, <br />4 1 <br />(Signature of person being issued the rionce) <br />Wfiitc ('01)V: PLIMC W(9ate (ireen opy: Fil" 4 Mkm C opy R�pml Copy Pink top lkecpent fk)ld Cop : Offii,xr Appe�d jionce Rou"', 44 1)31 <br />