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I <br />notified that you are prohibited from (check box): <br />9 <br />T you violated Section L-"0jJq <br />he basis f ®r this N tie e of stricti <br />Reon of Use i that s on A410 , —f-1 I of the Pat <br />and Open Space Rules, and/or Section AAH _ of the Eugene Code, 1471 and/or ORS To wit, you <br />(Description of the violation.) <br />- I a <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 anti Open Space Rule R- 1 .074 you are entitled to an Infornial hearing to contest this No ice. A request for an <br />informal hearing must be inade in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />within 48 hours (exclusive of weekends) OfTOceipt of this Notice at the t6flowing 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 infonmal 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 shall remaln in effect pending any requested hearing. <br />This Notice of Exclusion was delivered to the person named at the top of this Notice at the daty and time shown above by: <br />......... . <br />(Signature of person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and tirne indicated above. <br />(Signature of person being issued the notice) <br />Wh i 9 c Cu Public wal Green Copy; File Yellow Copy Report Copy Pink Copy: Recipient Gold Copy� Offi ca Appea notice Kev, 04/03 <br />Nunie; La, First Midifle <br />DOB� <br />ex: <br />Q hfv)t <br />W <br />C4 <br />Res i <br />- Address: Cit <br />State <br />1 <br />Ezi P � <br />=Res� Phone: <br />Work Phonc� <br />U-7 <br />I <br />notified that you are prohibited from (check box): <br />9 <br />T you violated Section L-"0jJq <br />he basis f ®r this N tie e of stricti <br />Reon of Use i that s on A410 , —f-1 I of the Pat <br />and Open Space Rules, and/or Section AAH _ of the Eugene Code, 1471 and/or ORS To wit, you <br />(Description of the violation.) <br />- I a <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 anti Open Space Rule R- 1 .074 you are entitled to an Infornial hearing to contest this No ice. A request for an <br />informal hearing must be inade in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />within 48 hours (exclusive of weekends) OfTOceipt of this Notice at the t6flowing 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 infonmal 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 shall remaln in effect pending any requested hearing. <br />This Notice of Exclusion was delivered to the person named at the top of this Notice at the daty and time shown above by: <br />......... . <br />(Signature of person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and tirne indicated above. <br />(Signature of person being issued the notice) <br />Wh i 9 c Cu Public wal Green Copy; File Yellow Copy Report Copy Pink Copy: Recipient Gold Copy� Offi ca Appea notice Kev, 04/03 <br />