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NOTICE OF RESTRICTION OF USE <br />and Notice Of Right to Appeal <br />DATE. TIME: ASE C <br />Le?p_ <br />LOCATION (PARK/OPEN SPACE):we 9Loer—' <br />JADO� <br />5 - 00 ZLO <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 />n lr <br />at ted that you are prohibited from (check box): <br />Entering in or using all City of Eugene parks, open spaces or facilities. <br />and Open Space Rules, and/or Section of the Eugene Code, 197 1, arid/or ORS To wit, you:_ <br />(Description of the violation.) <br />This restriction of use is effective beginning an and shall remain in effect until 0 1 <br />If you enter in or use any City of Eugene park,, open space or facility during the effective period of this Notice, you inay be <br />arrested and charged with criminal trespass in the second degree. <br />pursuant to Park and Open Space Rule R- I .O 74 you are entitled to an infannal heari n g 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 Divigion Director shall schedule a time and place for the informal hearing to be conducted, which shall be not irrore than <br />7.2 hours (exclusive of weekends� ofrecelpt 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 t�e <br />incident, The Division Direclor 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 ol'this N(01)tiche date acid shown above by: <br />e�4 - , I <br />2nature 0 <br />ignature of person isswing/delivering tiotice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />(Signature of person Tieing issued th n6tice) <br />WhiEr Cupy: Public Works Green Cepy File Ve I I ow Copy; Report C opy Pink Copy: Recipicnt Goid Copy Officer Appeal nnak!e Rev, 04U <br />Name: Last F t '"i"Ic <br />DOB: <br />P's <br />r6 <br />Res. Addre&s: city <br />state <br />Zip <br />kes, Phone: <br />Work Phone� <br />—Y r <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 />n lr <br />at ted that you are prohibited from (check box): <br />Entering in or using all City of Eugene parks, open spaces or facilities. <br />and Open Space Rules, and/or Section of the Eugene Code, 197 1, arid/or ORS To wit, you:_ <br />(Description of the violation.) <br />This restriction of use is effective beginning an and shall remain in effect until 0 1 <br />If you enter in or use any City of Eugene park,, open space or facility during the effective period of this Notice, you inay be <br />arrested and charged with criminal trespass in the second degree. <br />pursuant to Park and Open Space Rule R- I .O 74 you are entitled to an infannal heari n g 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 Divigion Director shall schedule a time and place for the informal hearing to be conducted, which shall be not irrore than <br />7.2 hours (exclusive of weekends� ofrecelpt 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 t�e <br />incident, The Division Direclor 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 ol'this N(01)tiche date acid shown above by: <br />e�4 - , I <br />2nature 0 <br />ignature of person isswing/delivering tiotice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />(Signature of person Tieing issued th n6tice) <br />WhiEr Cupy: Public Works Green Cepy File Ve I I ow Copy; Report C opy Pink Copy: Recipicnt Goid Copy Officer Appeal nnak!e Rev, 04U <br />