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NOTICE OF RESTRICTION OF USE <br />DATE: W_zjr1L9__ <br />pwvgjl���� <br />TIME: Z I Lit) CASE #- ) __ 14 <br />LOCATION (PAR KJOPEN SPACE): C TEF Pe"e_j A <br />Under the authority of Administrative Order No. 58-03-24-F and Park and Open Space Rule - 1 .005(3), you are hereby <br />notified that you are prohibited frown (check box): <br />Entering in or using all City of Eugene parks, open spaces or facilities- <br />( Description of the violation.) <br />This vestriction of use is effective beginning on 4 --ZkAq-1 and shall remain in effect until 0 7") 4 -5. <br />If you enter in or use any City of Eugene park, open space or facility during the effective period of this Notice, you may be <br />arrcsted 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 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) of receipt 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 />72 hours (,exclusive of weekends) of receipt of the request for hearing. At the informal hearing the Division Director will only <br />consider testimony from you City personnel involved in the incident that resulted in this Notice, kind 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 Exclusion was delivered to the person named tit the top of this Notice at the date and time shown above by: <br />gr <br />Signatu <br />(S re f person issuing./delivering not]CO <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />O <br />(Signature of person being, issued the notice) <br />Whac Copy: Public Works Green Copy: Fite Yellow Copy: Reps n Cope Pink Copy: Recipient Gold Copy: Offiecv Appeal notice Rev. 04'03 <br />Name: Last First Middle <br />DOB: <br />R,ace/Se4: <br />Res. Address: City T <br />State <br />Zip <br />Res. Phone: <br />Work Phone: <br />Under the authority of Administrative Order No. 58-03-24-F and Park and Open Space Rule - 1 .005(3), you are hereby <br />notified that you are prohibited frown (check box): <br />Entering in or using all City of Eugene parks, open spaces or facilities- <br />( Description of the violation.) <br />This vestriction of use is effective beginning on 4 --ZkAq-1 and shall remain in effect until 0 7") 4 -5. <br />If you enter in or use any City of Eugene park, open space or facility during the effective period of this Notice, you may be <br />arrcsted 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 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) of receipt 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 />72 hours (,exclusive of weekends) of receipt of the request for hearing. At the informal hearing the Division Director will only <br />consider testimony from you City personnel involved in the incident that resulted in this Notice, kind 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 Exclusion was delivered to the person named tit the top of this Notice at the date and time shown above by: <br />gr <br />Signatu <br />(S re f person issuing./delivering not]CO <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />O <br />(Signature of person being, issued the notice) <br />Whac Copy: Public Works Green Copy: Fite Yellow Copy: Reps n Cope Pink Copy: Recipient Gold Copy: Offiecv Appeal notice Rev. 04'03 <br />