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Under the authority of Administrative Order No. 58-03-24-F find Park and Open Space Rule R-1.005(3), you are hereby
<br />notified that you are prohibited from (check box):
<br />Entering in or using all City of Eugrene parks, open spaces or facilities.
<br />a
<br />The basis for this Notice of Restriction of Use is that on you violated Section .1-1---1111101IJ of the Park
<br />and Open Space RUles, and/or Section ofthe Eugene Code, 1071, and/or OR To wit, yot,i:____
<br />\ " u - PPIYZI� -
<br />(Description ofthe violation,)
<br />and shall remain in effect until
<br />II'vou enter in or its(, any ('ity of L'ugene 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 RuIc R -1.074 you are entitled to an informal hearing to contest this Notice. A request for an
<br />informal hearing most be made in writing and filed with the Parks & Open Space Division Director ("the Divis Director
<br />within 48 hours (exclusive of weekends) of receipt. oftfus Notice at the following address: 1820 Roosevelt, Blvd., Eugene, OR
<br />97402,
<br />The Division Director shall schedule a time and place for the informal hearing to be conducted, which shall be not rnore than
<br />72 hours (exclusive of weekends) of receipt of the request for hearing. At the informal hearing tire Division Director wil I only
<br />consider testimony From you, Gly personnel involved in the incident that restilied in this Notice, and other witnesses to the
<br />incident. The Division Director may exclude anyone, other than you and those presenting testimony, from the informal hearing,
<br />This Notice shall remain in effect pending any requested hearing.
<br />This Notice of Lxclusion was delivered to the person named at the top ofil"ns Notice at the date and time shown above by:
<br />17
<br />(Signature of person issuing/delivering notice)
<br />I hereby acknowledge receipt of the above, Notice on the date and time indicated above,
<br />(Slgriature ofperson heing issued the notice)
<br />While Cop : Public Woiks Glees Copy� File Yellow ( opy: Repol 14 opt Pink ( upv: Rcopmi� GoW Copv: Offliccr Appeal no ice Re% - 04413
<br />Narne: Last First Middle
<br />1)013
<br />Raccise%
<br />7
<br />Res, Addres: City
<br />State
<br />Zip
<br />Res Phc
<br />Work Phone:
<br />7
<br />Under the authority of Administrative Order No. 58-03-24-F find Park and Open Space Rule R-1.005(3), you are hereby
<br />notified that you are prohibited from (check box):
<br />Entering in or using all City of Eugrene parks, open spaces or facilities.
<br />a
<br />The basis for this Notice of Restriction of Use is that on you violated Section .1-1---1111101IJ of the Park
<br />and Open Space RUles, and/or Section ofthe Eugene Code, 1071, and/or OR To wit, yot,i:____
<br />\ " u - PPIYZI� -
<br />(Description ofthe violation,)
<br />and shall remain in effect until
<br />II'vou enter in or its(, any ('ity of L'ugene 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 RuIc R -1.074 you are entitled to an informal hearing to contest this Notice. A request for an
<br />informal hearing most be made in writing and filed with the Parks & Open Space Division Director ("the Divis Director
<br />within 48 hours (exclusive of weekends) of receipt. oftfus Notice at the following address: 1820 Roosevelt, Blvd., Eugene, OR
<br />97402,
<br />The Division Director shall schedule a time and place for the informal hearing to be conducted, which shall be not rnore than
<br />72 hours (exclusive of weekends) of receipt of the request for hearing. At the informal hearing tire Division Director wil I only
<br />consider testimony From you, Gly personnel involved in the incident that restilied in this Notice, and other witnesses to the
<br />incident. The Division Director may exclude anyone, other than you and those presenting testimony, from the informal hearing,
<br />This Notice shall remain in effect pending any requested hearing.
<br />This Notice of Lxclusion was delivered to the person named at the top ofil"ns Notice at the date and time shown above by:
<br />17
<br />(Signature of person issuing/delivering notice)
<br />I hereby acknowledge receipt of the above, Notice on the date and time indicated above,
<br />(Slgriature ofperson heing issued the notice)
<br />While Cop : Public Woiks Glees Copy� File Yellow ( opy: Repol 14 opt Pink ( upv: Rcopmi� GoW Copv: Offliccr Appeal no ice Re% - 04413
<br />
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