NOTICE OF RESTRICTION OF USE Lm <br />and Notice of Right to Appeal <br />DATE: TIME. CASE#. <br />LOCATION (PAlZK "OPEN SPACE): <br />1) , I V- \S� V 1- <br />M <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 />A Entering in or using all City of Eugene parks, open spaces or facilities. <br />ri <br />The basis for this Notice of Restriction of Use is that ona]0746--1 you violated Section 6f the Park <br />and Open Space Rules, at Scctiori� �,j of the Eugene Code, 19'71, and/or 0 RS To wit, you:_ <br />FU <br />W51 <br />17 ef RLJ le <br />on 4 <br />If you enter in or use any City of Eugene park open space or facility during the effective period ol'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 itifornial hearing to contest this Noficc: 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 Notiee at the following address: 1820 Roosevelt, Blvd, Eugene, OR <br />97402. <br />The Division Director shall schedule a time and place for the inibri 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, and other witnesses to the <br />incident, The Division Director may exclude anyone, other than you and those presenting testimony, from the info al hearing. <br />This Notice shall remain in effect pending any requested hearing. <br />This Notice of Exclusion was delivered to the person named at the top of this Notic tthe%clati and above by: <br />S rani re of person s <br />this; 1" <br />I hereby acknowledge receipt of the above Notice on the date and tirne indicated above. <br />611 lure of' P on bei i- the nonce) <br />White Ccipy: Public Works Grcen Copy; File Yellow cklpy; Rcporl Copy Pink Copy: RuOpicnl, Gold Copy: 0 tYi cer Appeal m o6cu Rpv- 04103 <br />Name: 111 <br />First <br />N-fi(iffle <br />JA <br />i - )0 1 i <br />�,X I ress: <br />Citv <br />Sta ti, <br />Z' <br />R.", Phone <br />Work Phone: <br />N 51— �je <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 />A Entering in or using all City of Eugene parks, open spaces or facilities. <br />ri <br />The basis for this Notice of Restriction of Use is that ona]0746--1 you violated Section 6f the Park <br />and Open Space Rules, at Scctiori� �,j of the Eugene Code, 19'71, and/or 0 RS To wit, you:_ <br />FU <br />W51 <br />17 ef RLJ le <br />on 4 <br />If you enter in or use any City of Eugene park open space or facility during the effective period ol'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 itifornial hearing to contest this Noficc: 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 Notiee at the following address: 1820 Roosevelt, Blvd, Eugene, OR <br />97402. <br />The Division Director shall schedule a time and place for the inibri 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, and other witnesses to the <br />incident, The Division Director may exclude anyone, other than you and those presenting testimony, from the info al hearing. <br />This Notice shall remain in effect pending any requested hearing. <br />This Notice of Exclusion was delivered to the person named at the top of this Notic tthe%clati and above by: <br />S rani re of person s <br />this; 1" <br />I hereby acknowledge receipt of the above Notice on the date and tirne indicated above. <br />611 lure of' P on bei i- the nonce) <br />White Ccipy: Public Works Grcen Copy; File Yellow cklpy; Rcporl Copy Pink Copy: RuOpicnl, Gold Copy: 0 tYi cer Appeal m o6cu Rpv- 04103 <br />