Nsj!Sj�(� 5 <br />tinder the authority of Administrative Order N'o. 58-03-24-F and Park and Open Space Rule 11-1.005(3), you are herebv <br />notified that you are prohibited from (check box): <br />Entering in or using all City ol'Eugene parks, open spaces or facilities. <br />The, basis for this Notice of Restriction ofUse is that on I you violated Section of the Park <br />and Open Space Rules, and "'or Section - — - of the Eugene Code, 1 971, andlior OR To wit, you:--"'.— <br />(Description of the violation.) <br />This restriction of use is effective beginning on and shall remain in effect unfil 7 <br />mm <br />4- <br />If you enter in or use any City ofELIgene park, open sporce or thellity derma the effective period offlus, Notice, you may be <br />arrested and charged with criminal trespass in the second degree, <br />Pursuant to Park arid Open Space Rule 11 - 1.074 you are entitled to an infi. hearing to contest this Notice, A request f7 r an <br />infortnal 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 f 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />The Division Director shall schedUlC a time and place for the inforim] treating to be conduoed, which shall be not more 1han <br />'2 hours (exclusive of weekends) of receipt ofthe request for hearing, At the infork licarin the Division Director will only <br />consider testimony front you, City personnel involved in the incident that resulted in this Notice, and other witnesses to the <br />incident, The Division Director rnay CXCILideanyone, other than VOLiand those presenting testimony, frorn the iril'ornioll hcaring, <br />"I'his Notice shall remain in effect pending any requested hearing. <br />This 'Notice of Exclus.ion was delivered to the person named at the top ofthis Notice at the date and time shown above bv: <br />( Si a[ure 01 issuin&/defi vering notice,,) <br />I hereby acknowledge receipt of the above Notice on the done and time indicated above, <br />'J <br />kSignature ofpers'on being issued the notice) <br />Vu11 I te ( - o pv, P u h I i C ", o rk ,, Owl ( opy: NIC Ydlmv o[',y: Repoo ( opy Pink ( opy: Recipiew (,Ad ( opy: Offiw'�i Appeal ju,lice ke " 0 01, <br />Minis: Last Fi M i(fdle <br />DOB: <br />RaceL Se <br />lfl L fQ <br />Re Mdrcs's: Citv <br />State <br />Zip <br />Re llhcme� <br />WCWk 1 <br />tinder the authority of Administrative Order N'o. 58-03-24-F and Park and Open Space Rule 11-1.005(3), you are herebv <br />notified that you are prohibited from (check box): <br />Entering in or using all City ol'Eugene parks, open spaces or facilities. <br />The, basis for this Notice of Restriction ofUse is that on I you violated Section of the Park <br />and Open Space Rules, and "'or Section - — - of the Eugene Code, 1 971, andlior OR To wit, you:--"'.— <br />(Description of the violation.) <br />This restriction of use is effective beginning on and shall remain in effect unfil 7 <br />mm <br />4- <br />If you enter in or use any City ofELIgene park, open sporce or thellity derma the effective period offlus, Notice, you may be <br />arrested and charged with criminal trespass in the second degree, <br />Pursuant to Park arid Open Space Rule 11 - 1.074 you are entitled to an infi. hearing to contest this Notice, A request f7 r an <br />infortnal 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 f 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />The Division Director shall schedUlC a time and place for the inforim] treating to be conduoed, which shall be not more 1han <br />'2 hours (exclusive of weekends) of receipt ofthe request for hearing, At the infork licarin the Division Director will only <br />consider testimony front you, City personnel involved in the incident that resulted in this Notice, and other witnesses to the <br />incident, The Division Director rnay CXCILideanyone, other than VOLiand those presenting testimony, frorn the iril'ornioll hcaring, <br />"I'his Notice shall remain in effect pending any requested hearing. <br />This 'Notice of Exclus.ion was delivered to the person named at the top ofthis Notice at the date and time shown above bv: <br />( Si a[ure 01 issuin&/defi vering notice,,) <br />I hereby acknowledge receipt of the above Notice on the done and time indicated above, <br />'J <br />kSignature ofpers'on being issued the notice) <br />Vu11 I te ( - o pv, P u h I i C ", o rk ,, Owl ( opy: NIC Ydlmv o[',y: Repoo ( opy Pink ( opy: Recipiew (,Ad ( opy: Offiw'�i Appeal ju,lice ke " 0 01, <br />