1.28.15 Park Restrictions - Laserfiche WebLink

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NOTICE OF RES'I' RICTION OF USE and Notice of Right to Appeal DATE: (A TIME: CASE # 5�g�51ei521� t!!; LOCATION (PARK/OPEN SPACE): PAIL Under the authority of Administrative Order No. 58-03-24-F and Park and Open Space Rule R-1.005(3), you are hereby notified that you are prohibited from (check box)- Entering in or using all City of Eugene parks, open spaces or facilities. V The basis for this Notice of Restriction of Use is that on 01 IL 1 [/-T you violated Section- the Park and Open Space Rules, and/or Section All—qo— of` the Eu gene Code, 11371, and/or ORS —. To wit you:_ I ------ Lv- t; A (Description of the violation.) This restrct and shall remain in effect until restriction of use is effectiv e beginning ona—k W - _ 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 arrested and charged with criminal trespass in the second degree. Pursuant to Park and Open Space Rule R-1,074 youare entitled to an informal hearing to contest this Notice. A request for an inforinal hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Director") weekends I of rg�ei�Qt of1his NOtice at t�e ffillowino m1dre V220 Roa%evelt,, Vilvd., F-1121UL-U& ne i-livision Mrecior sna 7 a time an Te 17777mai nearing to e conaucte a 72 hours exclusive of weekends) of receipt (if ffic request for hearing. At the informal hearing the Division Director will only consider testimony from you, City personnel involved in the incident that resulted in this Notice, and other witnesses to the incident. The Division Director may exclude anyone, other than you and those presenting testimony, from the informal hearing. Th is N otice shall rema in in effect pending an y req uested h earing. This Notice o4` Excl usion was delivered to the person named at the top of this Notice at the date and time shown above by: c �V—, ( Signature of person issuing/del ivering notice) I hereby acknowledge receipt of the above Notice on the date and time indicated above. A, (Signature of person being issued the notice) Whitc Copy Public Works Crean Copy: File Yellow copy: Rcport Copy Pink Copy Recipient Gold Copy: Officer Appeal notice Re%, 114/03 Name: Last First Middle DOB R - a cle/se.- U Res. address: City State dip Res. Phone: Work Phone: Under the authority of Administrative Order No. 58-03-24-F and Park and Open Space Rule R-1.005(3), you are hereby notified that you are prohibited from (check box)- Entering in or using all City of Eugene parks, open spaces or facilities. V The basis for this Notice of Restriction of Use is that on 01 IL 1 [/-T you violated Section- the Park and Open Space Rules, and/or Section All—qo— of` the Eu gene Code, 11371, and/or ORS —. To wit you:_ I ------ Lv- t; A (Description of the violation.) This restrct and shall remain in effect until restriction of use is effectiv e beginning ona—k W - _ 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 arrested and charged with criminal trespass in the second degree. Pursuant to Park and Open Space Rule R-1,074 youare entitled to an informal hearing to contest this Notice. A request for an inforinal hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Director") weekends I of rg�ei�Qt of1his NOtice at t�e ffillowino m1dre V220 Roa%evelt,, Vilvd., F-1121UL-U& ne i-livision Mrecior sna 7 a time an Te 17777mai nearing to e conaucte a 72 hours exclusive of weekends) of receipt (if ffic request for hearing. At the informal hearing the Division Director will only consider testimony from you, City personnel involved in the incident that resulted in this Notice, and other witnesses to the incident. The Division Director may exclude anyone, other than you and those presenting testimony, from the informal hearing. Th is N otice shall rema in in effect pending an y req uested h earing. This Notice o4` Excl usion was delivered to the person named at the top of this Notice at the date and time shown above by: c �V—, ( Signature of person issuing/del ivering notice) I hereby acknowledge receipt of the above Notice on the date and time indicated above. A, (Signature of person being issued the notice) Whitc Copy Public Works Crean Copy: File Yellow copy: Rcport Copy Pink Copy Recipient Gold Copy: Officer Appeal notice Re%, 114/03