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LOCATION (PARK/OPEN SPACE): V-1�1415 <br />Under the authority of Administrative Order No. 58603-24-F and park. acrd 0pen Space Rule R-1.005(3),you are herehv <br />notified that you are prohibited from (check box): <br />1( Entering in or using all City of Eugene parks, open spaces or facilities. <br />X <br />The basis for this Notice of Restriction of Use is that on you violated Section jkC� ' O of the Park <br />and Open Space Rules, and/or Section of the F ugene Code, 19 7 1, and/or ORS To wit, you:_ <br />(Description of the violation.) <br />I -Zl—1 <br />This restriction of use is effective beginning on and! shall, remain in effect until <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 />arrested 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 riled 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 shal schedul c a time and p lace for th infonrial hearing to be conducted, which shal be riot more than <br />72 hours ( exclusive exclusive ot'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, 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 %hall remain in effect pending any requested hearing. <br />This Notice oF Exclusion was delivered to the person named at the top ofthis Notice at the date and tirne shown above by: <br />(Signu ure of person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />rJ <br />(Signature of person being issued the notice) <br />White Copy. Public Works Green Copy Pile Yellow Cupy: Report Copy Fink Copy: Recipient Gold Copy: Officer Appeal nukicQ Rev, 114# <br />Namc� Last First Middle <br />DoFi! <br />f <br />Oil <br />.j <br />Res rr City <br />State <br />Zip <br />Rcw, Phone: <br />Work Phonc: <br />Ls' Jj <br />Under the authority of Administrative Order No. 58603-24-F and park. acrd 0pen Space Rule R-1.005(3),you are herehv <br />notified that you are prohibited from (check box): <br />1( Entering in or using all City of Eugene parks, open spaces or facilities. <br />X <br />The basis for this Notice of Restriction of Use is that on you violated Section jkC� ' O of the Park <br />and Open Space Rules, and/or Section of the F ugene Code, 19 7 1, and/or ORS To wit, you:_ <br />(Description of the violation.) <br />I -Zl—1 <br />This restriction of use is effective beginning on and! shall, remain in effect until <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 />arrested 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 riled 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 shal schedul c a time and p lace for th infonrial hearing to be conducted, which shal be riot more than <br />72 hours ( exclusive exclusive ot'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, 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 %hall remain in effect pending any requested hearing. <br />This Notice oF Exclusion was delivered to the person named at the top ofthis Notice at the date and tirne shown above by: <br />(Signu ure of person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />rJ <br />(Signature of person being issued the notice) <br />White Copy. Public Works Green Copy Pile Yellow Cupy: Report Copy Fink Copy: Recipient Gold Copy: Officer Appeal nukicQ Rev, 114# <br />