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Under 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 (check box): <br />Entering in or using all City of Eugene parks, open spaces or facilities. <br />The basis for this Notice of Restriction of Use is that on 1, 7—A you violated Section of the Park <br />and Open Space Rules, and/or Section — of the Eugene Code, 1471, andlor ORS To wit, you: <br />Pursuant to Park and Open Space Rule R.- 1.074 you are entitled to an informal hearing to contest this Notice. A request for an <br />informal 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) ofreceipt of this 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 more than <br />7? hours ( of weekends) of receipt of the request for hearing. At the informal hearing the Division Director wi only <br />consider testimony from you, City personnel involved in the incident that resulted in this Notice, and other witnesse% 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 bearing. <br />This Notice of Exclusion was delivered to the person named at the top of this Notice at the date and time shown above by: <br />(Sig lire of person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notiec on the date and time indicated above. <br />I <br />ol\j _YJ <br />(Signature of person being issued the notice) <br />While Copy, Public Works Green Copyi File Yellow Copy: Rcporl Copy Pink Copy! RecJpieut Guld Copy: Orricer Appvai notice Rcv, 91410 <br />Name: Last First X-I i d d I o <br />DGB� <br />Racw,'Sev <br />Res. Address: City <br />Ite <br />Zip <br />Res, Phone: <br />Work Phone: <br />- T - A <br />Under 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 (check box): <br />Entering in or using all City of Eugene parks, open spaces or facilities. <br />The basis for this Notice of Restriction of Use is that on 1, 7—A you violated Section of the Park <br />and Open Space Rules, and/or Section — of the Eugene Code, 1471, andlor ORS To wit, you: <br />Pursuant to Park and Open Space Rule R.- 1.074 you are entitled to an informal hearing to contest this Notice. A request for an <br />informal 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) ofreceipt of this 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 more than <br />7? hours ( of weekends) of receipt of the request for hearing. At the informal hearing the Division Director wi only <br />consider testimony from you, City personnel involved in the incident that resulted in this Notice, and other witnesse% 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 bearing. <br />This Notice of Exclusion was delivered to the person named at the top of this Notice at the date and time shown above by: <br />(Sig lire of person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notiec on the date and time indicated above. <br />I <br />ol\j _YJ <br />(Signature of person being issued the notice) <br />While Copy, Public Works Green Copyi File Yellow Copy: Rcporl Copy Pink Copy! RecJpieut Guld Copy: Orricer Appvai notice Rcv, 91410 <br />